Anti-VEGF Therapy Does Not Increase Glaucoma Drainage Device Erosion Risk

Intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) for diabetic retinopathy are not associated with an increased rate of glaucoma drainage device erosions, according to research published in Clinical Ophthalmology.

Researchers conducted a retrospective chart review to determine if intravitreal injections of anti-VEGF are associated with an increased risk of glaucoma drainage device erosions in patients with diabetic retinopathy. 

The team compared the rate of glaucoma drainage device erosions between eyes that did or did not receive intravitreal injections of anti-VEGF and evaluated the relationship between diabetic macular edema (DME) and intravitreal steroid injections and glaucoma drainage device erosions.

A total of 677 eyes of 608 patients (55.9% men and 44.1% women; average age, 65.6 years), were included in the study. Most patients were of Hispanic/Latino (42.8%), Black (42.1%), White (11.7%), or Asian (1.3%)ethnicity. A total of 447 eyes (66%) received at least 1 anti-VEGF injection, and the remaining 230 eyes (34%) never received anti-VEGF therapy. 

The investigation shows no significant difference in proportion of eyes that had 1 or more erosion events among those receiving anti-VEGF therapy compared with those not receiving anti-VEGF therapy (4.5% vs 3.0%; odds ratio, 1.49; P =.37). However, the research shows that diabetic macular edema is associated with a significantly increased rate of erosion in eyes not receiving anti-VEGF therapy (71.4% vs 31.4%; P=.034) but not in eyes receiving anti-VEGF therapy (30.0% vs 40.7%; P =.34). 

The team demonstrated that eyes receiving more than 1 specific anti-VEGF agent, an increased frequency or total number of anti-VEGF injections, or intravitreal steroids were not associated with a significantly increased risk of erosion.

“In conclusion, anti-VEGF therapy was not associated with an increased rate of [glaucoma drainage device] erosions or an increased number of [glaucoma drainage device] erosions in eyes that experienced at least one erosion event. However, the presence of DME was associated with a higher risk of [glaucoma drainage device] erosion in eyes not receiving anti-VEGF therapy,” researchers explain.

Limitations of the study included the relatively small number of eyes with glaucoma drainage device erosions compared with the number of eyes that did not have glaucoma drainage device erosions, relatively short follow-up duration after glaucoma drainage device placement, and possible confounding effects of different surgical methods between surgeons.