玻璃体腔注药后眼压变化及其影响因素

Intraocular pressure after intraviitreal injection of drugs

糖皮质激素、抗血管内皮生长因子药物、抗生素、抗病毒药物是目前临床常用的4类玻璃体腔注射药物。药物经玻璃体腔注射后，受药物种类、注射剂量以及患者年龄、性别、眼轴、玻璃体液化返流等因素的影响，可出现短期或长期眼压升高。短期眼压升高通常表现为注药后2周内出现一过性的眼压升高，大部分患者无需治疗即可自然恢复至正常水平，少部分眼压升高明显者可考虑前房穿刺或应用降眼压药物治疗等干预措施。长期眼压升高是指注药2周后眼压持续升高，可引起视神经不可逆损害，导致患者视功能下降。因此，眼压升高明显且持续时间较长者，需要考虑行药物或手术干预措施。如何全面认识和评估药物以及患者自身因素对玻璃体腔注射后眼压的影响、是否有必要以及如何在注射前预防性采取降眼压措施均需要进一步大规模多中心临床试验研究证实。

Corticosteroids, anti-vascular endothelial growth factor, antibiotics and antiviral were the main 4 classes of drugs for intravitreal injection. Depending on the class and volume of medication, age and gender of patients, ocular axial lengths or vitreous humour reflux, intraocular pressure （IOP） can be elevated transiently or persistently after intravitreal injection. Transient IOP elevation occurred in 2 weeks after intravitreal injection, and can be reduced to normal level for most patients. Only a small portion of such patients have very high IOP and need intervention measures such as anterior chamber puncture or lowering intraocular pressure by drugs. Long term IOP elevation is refers to persistent IOP increase after 2 weeks after intravitreal injection, and cause optic nerve irreversible damage and decline in the visual function of patients. Thus drug or surgical intervention need to be considered for those patients with high and long period of elevated IOP. Large-scale multicenter clinical trials need to be performed to evaluate the roles of the drug and patients factors for IOP of post- intravitreal injection, and to determine if it is necessary and how to use methods reducing IOP before intravitreal injection.