Effect of Vascular Endothelial Growth Factor Blockers on Aqueous Humor Dynamics
The objective of this research is to determine the effects of anti-VEGF drugs (bevacizumab, ranibizumab or aflibercept) on aqueous humor dynamics (AHD) in patients with retinal vascular disease. The underlying hypothesis is that anti-VEGF drugs increase intraocular pressure (IOP) by increasing aqueous inflow, decreasing uveoscleral outflow or both. The specific aim is to evaluate the changes produced in AHD after 1 baseline and a subsequent 1 monthly injection of anti VEGF agents.
• Subjects must be at least 19 years of age and older
• Ability to give informed consent and attend the study visits
• Patients with established diagnosis of retinal vascular diseases (diabetic macular edema, neovascular macular degeneration,presumed ocular histoplasmosis syndrome, high myopia) who require intravitreal injection of anti-VEGF drugs such as bevacizumab,ranibizumab or aflibercept and are likely to need three monthly doses.
• Patients who have not received intravitreal injections within 3 months of study entry
• No previous established diagnosis of glaucoma and consequently no previous history of Argon Laser Trabeculoplasty (ALT) or Selective Laser Trabeculoplasty (SLT).
• No previous history of ocular surgery
• Patients who are not planning on and are unlikely to require an elective ocular surgical or laser procedure within the study duration
• Open angle of the anterior chamber on clinical examination
• Ability to cooperate for aqueous humor dynamic studies
• Contact lenses removed prior to topical fluorescein instillation, and not used until the end of each fluorophotometry session
• Able to participate on site over the multi-visit study period