J Korean Ophthalmol Soc.  2017 Apr;58(4):401-407. 10.3341/jkos.2017.58.4.401.

The Effect of Intravitreal Injection on the Corneal Endothelium

Affiliations
  • 1Department of Ophthalmology, Guri Hospital, Hanyang University College of Medicine, Guri, Korea. hycho@hanyang.ac.kr

Abstract

PURPOSE
To evaluate the effect of intravitreal injection on the corneal endothelium according to the injected drug.
METHODS
The present study included 118 eyes of 113 patients who received intravitreal injection. Before each injection and 1 month after the injection, specular microscopy was performed to evaluate the corneal endothelial changes and central corneal thickness. We classified the patients according to the injected drug (bevacizumab 21 eyes, ranibizumab 20 eyes, aflibercept 47 eyes, dexamathasone implant 30 eyes), phakic or pseudophakic eyes, single or multiple injections and analyzed them retrospectively.
RESULTS
The mean corneal endothelial cell density was 2,693.2 ± 298.2 cells/mm² before injection and 2,686.8 ± 288.7 cells/mm² 1 month after injection, and there was no statistically significant difference (p = 0.731). According to the kind of drug, the mean corneal endothelial cell density and central corneal thickness were not significantly different before and 1 month after injection in any of the 4 groups.
CONCLUSIONS
There were no significant changes in corneal endothelium before and 1 month after intravitreal injection of the various drugs.

Keyword

Corneal endothelium; Intravitreal injection; Specular microscopy

MeSH Terms

Endothelial Cells
Endothelium, Corneal*
Humans
Intravitreal Injections*
Microscopy
Ranibizumab
Retrospective Studies
Ranibizumab

Reference

References

1. Peyman GA, Lad EM, Moshfeghi DM. . Intravitreal injection of therapeutic agents. Retina. 2009; 29:875–912.
Article
2. Sawada O, Kawamura H, Kakinoki M. . Vascular endothelial growth factor in aqueous humor before and after intravitreal in-jection of bevacizumab in eyes with diabetic retinopathy. Arch Ophthalmol. 2007; 125:1363–6.
Article
3. Bayar SA, Altinors DD, Kucukerdonmez C, Akova YA. . Severe corneal changes following intravitreal injection of bevacizumab. Ocul immunol inflamm. 2010; 18:268–74.
Article
4. Wilson SE, Lloyd SA, He YG. . Glucocorticoid receptor and inter-leukin-1 receptor messenger RNA expression in corneal cells. Cornea. 1994; 13:4–8.
Article
5. Bourne RR, Minassian DC, Dart JK. . Effect of cataract sur-gery on the corneal endothelium: modern phacoemulsification compared with extracapsular cataract surgery. Ophthalmology. 2004; 111:679–85.
6. Jacobs P, Cheng H, Price NC. . Endothelial cell loss after cata-ract surgery–the problem of interpretation. Trans Ophthalmol Soc U K. 1982; 102:(pt 2):291-3.
7. Krohne TU, Eter N, Holz FG, Meyer CH. . Intraocular pharmacoki-netics of bevacizumab after a single intravitreal injection in humans. Am J Ophthalmol. 2008; 146:508–12.
Article
8. Beer PM, Bakri SJ, Singh RJ. . Intraocular concentration and pharmacokinetics of triamcinolone acetonide after a single intra-vitreal injection. Ophthalmology. 2003; 110:681–6.
Article
9. Stiernke MM, Watsky MA, Kangas TA, Edelhauser HF. . The estab-lishment and maintenance of corneal transparency. Prog Retin Eye Res. 1995; 14:109–40.
Article
10. Gordon MS, Cunningham D. . Managing patients treated with bev-acizumab combination therapy. Oncology. 2005; 69:Suppl 3:25-33.
Article
11. Rudge JS, Thurston G, Davis S. . VEGF trap as a novel anti-angiogenic treatment currently in clinical trials for cancer and eye diseases, and VelociGene-based discovery of the next generation of angiogenesis targets. Cold Spring Harb Symp Quant Biol. 2005; 70:411–8.
12. Chan CK, Fan DS, Chan WM. . Ocular-hypertensive response and corneal endothelial changes after intravitreal triamcinolone in-jections in Chinese subjects: a 6-month follow-up study. Eye (Lond). 2005; 19:625–30.
Article
13. Kuppermann BD, Blumenkranz MS, Haller JA. . Randomized controlled study of an intravitreous dexamethasone drug delivery system in patients with persistent macular edema. Arch Ophthalmol. 2007; 125:309–17.
Article
14. Chiang CC, Chen WL, Lin JM, Tsai YY. . Effect of bevacizumab on human corneal endothelial cells: a six-month follow-up study. Am J Ophthalmol. 2008; 146:688–91.
Article
15. Pérez-Rico C, Benítez-Herreros J, Castro-Rebollo M. . Effect of intravitreal ranibizumab on corneal endothelium in age-related macular degeneration. Cornea. 2010; 29:849–52.
Article
16. Suh SY, Lee JH, Jun RM. . Corneal endothelial change after intra-vitreal bevacizumab injection. J Korean Ophthalmol Soc. 2010; 51:1549–53.
Article
17. Kwak HW, D'Amico DJ. . Evaluation of the retinal toxicity and pharmacokinetics of dexamethasone after intravitreal injection. Arch Ophthalmol. 1992; 110:259–66.
Article
18. Ilhan N, Coskun M, Ilhan O. . Effect of intravitreal injection of dexamethasone implant on corneal endothelium in macular edema due to retinal vein occlusion. Cutan Ocul Toxicol. 2015; 34:294–7.
Article
19. Jamil AZ, Ahmed A, Mirza KA. . Effect of intracameral use of dex-amethasone on corneal endothelial cells. J Coll Physicians Surg Pak. 2014; 24:245–8.
20. Boyer DS, Faber D, Gupta S. . Dexamethasone intravitreal im-plant for treatment of diabetic macular edema in vitrectomized patients. Retina. 2011; 31:915–23.
Article
21. Khurana RN, Appa SN, McCannel CA. . Dexamethasone im-plant anterior chamber migration: risk factors, complications, and management strategies. Ophthalmology. 2014; 121:67–71.
22. Bansal R, Bansal P, Kulkarni P. . Wandering Ozurdex(®) implant. J Ophthalmic Inflamm Infect. 2012; 2:1–5.
Article
Full Text Links
  • JKOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr