The effect of acute rises in intraocular pressure after intravitreal bevacizumab injection on the peripapillary retinal nerve fiber layer thickness and the role of anterior chamber paracentesis

Purpose: To evaluate acute changes in intraocular pressure (IOP) and their short-term effects on the peripapillary retinal nerve fiber layer (RNFL) thickness after intravitreal bevacizumab (IVB) injection. Methods: Fifty-eight eyes of 37 patients with treatment-naive diabetic macular edema or exudative age-related macular degeneration were included in the study. Patients were divided into two groups, and the participants of each group received 3 monthly injections of IVB. IOP was measured right before the injection, immediately after the injection, and 5 min and 20 min after each injection. Peripapillary, RNFL thickness was measured before the injection and 1 month after the third injection. In the second group, anterior chamber (AC) paracentesis was performed before IVB injection. Results: IOP values after injection in all sessions were significantly higher in the first group (P Conclusion: AC paracentesis is an effective modality to reduce the acute rise in IOP. The effect of acute IOP elevation on the peripapillary RNFL thickness was not statistically significant.