Clinical Ophthalmology (Nov 2022)

Glaucoma Drainage Device Erosions in Patients Receiving Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Retinopathy

  • Islam YFK,
  • Vanner EA,
  • Maharaj ASR,
  • Schwartz SG,
  • Kishor K

Journal volume & issue
Vol. Volume 16
pp. 3681 – 3687

Abstract

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Yasmin Florence Khodeja Islam, Elizabeth A Vanner, Arindel SR Maharaj, Stephen G Schwartz, Krishna Kishor Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USACorrespondence: Krishna Kishor, Bascom Palmer Eye Institute, 7101 Fairway Drive, Palm Beach Gardens, Miami, FL, 33418, USA, Tel +1 561-515-1500, Fax +1 561-515-1588, Email [email protected]: To determine if intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are associated with an increased risk of glaucoma drainage device (GDD) erosions.Patients and Methods: A retrospective chart review was conducted including patients with diabetic retinopathy and had a GDD implanted at a large academic institution. The rate of GDD erosions was compared between eyes that did or did not receive intravitreal anti-VEGF injections. A subanalysis was also performed the relationship between diabetic macular edema (DME) and intravitreal steroid injections and GDD erosions.Results: A total of 677 eyes from 608 patients was included. A total of 447 eyes received at least one anti-VEGF injection; 230 eyes never received such therapy. Twenty eyes (4.5%) receiving anti-VEGF had at least one erosion event, compared to 7 eyes (3.0%) of patients not receiving anti-VEGF therapy (OR 1.49, p=0.37). Diabetic macular edema was associated with a significantly increased rate of erosion in eyes not receiving anti-VEGF (71.4% versus 31.4%, p=0.034), but not in eyes receiving anti-VEGF (30.0% versus 40.7%, p=0.34). Receiving more than one specific anti-VEGF agent, an increased frequency or total number of anti-VEGF injections, or receiving intravitreal steroids were not associated with an increased risk of erosion (p> 0.05).Conclusion: In patients with diabetic retinopathy, the use of anti-VEGF does not result in an increased rate of GDD erosions or recurrent erosions. Further research is needed over a longer follow-up period to determine if longer or more frequent anti-VEGF treatment is a risk factor for recurrent erosions.Keywords: diabetic retinopathy, glaucoma drainage device, tube erosion, anti-vascular endothelial growth factor

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