Incidence and Predictor of Ocular Hypertension after Intravitreal Injection of Bevacizumab among Patient Attended at KCMC Hospital

ObjectiveThis study aimed to evaluate the incidence, patterns, and determinants of ocular hypertension (OH) following Bevacizumab Intravitreal injections for various retinal diseases at KCMC Hospital, Tanzania. MethodsA prospective cohort study was conducted from August 2023 to July 2024, involving 120 participants. OH was defined as an intraocular pressure (IOP) >21 mmHg or an increase >5 mmHg from baseline. Data on demographics, injection history, ocular conditions, and systemic factors were collected. IOP was measured at baseline, immediately post-injection, and at six-week intervals during follow-up. Paired t-tests compared mean IOP differences, Nelson Allan estimator curves assessed cumulative OH risk, and Poisson regression identified associated factors. ResultsParticipants median age was 62 years, with diabetic macular edema (52.5%) being the most common indication. OH incidence was 15%, significantly associated with the number of injections (adjusted hazard ratio [AHR] 2.17, 95% CI 1.56-3.16, p < 0.001) and history of YAG laser capsulotomy (AHR 0.33, 95% CI 0.12-0.88, p = 0.028). Temporary post-injection IOP spikes normalized within 60 minutes. ConclusionThe study revealed a higher incidence of ocular hypertension following Bevacizumab injections compared to other studies. Significant factors included injection frequency and a history of YAG laser capsulotomy, with repeated injections leading to delayed normalization of intraocular pressure and increased spikes during subsequent visits.