Журнал клинической и экспериментальной офтальмологии
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ISSN: 2155-9570
ISSN: 2155-9570
Muataz Tareq M Ali, Zaid Rajab Hussein
Introduction: Hypertension is a common disease, which may be induced or precipitated by antivascular endothelial
growth factor therapy with many studies reporting this complication of this therapy.
Methods: This is a prospective study to evaluate blood pressure changes in normotensive, controlled and
uncontrolled hypertensive patients on regular medical treatment after a 0.05 ml (0.5 mg) intravitreal Ranibizumab
injection. It was held in Ibn-alhaitham eye teaching hospital in Baghdad between May 2019 and December 2019. It
included patients with variable retinal diseases receiving either unilateral or bilateral intravitreal Ranibizumab
injections, their blood pressure was measured before the treatment as a baseline, and then 2 hours, 1 month, and at 3
months from the first injection(s). These were allocated to three groups; Group A included normotensive patients
without history of hypertension; Group B included controlled hypertensives and those with grade 1 hypertension
with antihypertensive treatment. Group C included those with Grade 2 hypertension or more with antihypertensive
treatment. Blood pressure was measured in all patients using the manual sphygmomanometer in sitting position.
Paired t-test was used to analyze blood pressure measurements and compare mean arterial, systolic and diastolic
pressure. A P-value of ≤ 0.05 was considered significant, and a P-value of ≤ 0.001 was considered highly significant.
Results: Seventy-five patients (n=75) were included in the study with a mean age of 59.1 ± 11.4 years 58.7% males
and 41.3% females, 44% were controlled-hypertensives, 26.7% were uncontrolled-hypertensives, 29.3% were
normotensives. Group C showed highly significant reduction in the mean arterial, and systolic pressures in all three
measurements after baseline (P ≤ 0.001), and significant reduction of diastolic blood pressure at one and three
months after baseline (P ≤ 0.05). Both groups A and B showed a reduction in most measurements, but most were
statistically insignificant (P ≥ 0.05). Unilateral and bilateral injection groups showed similar reduction in the mean
arterial pressure at 2 hours and 3 months (P ≤ 0.05), mean systolic blood pressure was reduced in unilateral group in
all 3 measurements (P ≤ 0.05, P ≤ 0.05, P ≤ 0.001, respectively) and also in the bilateral group at 2 hours and 3
months (P ≤ 0.001, P ≤ 0.05 respectively), and mean diastolic blood pressure was reduced at 2 hours in the unilateral
group (P ≤ 0.05), and at 3 months in the bilateral injection group (P ≤ 0.05).
Conclusion: There is an overall reduction of blood pressure with Ranibizumab Intravitreal injections especially in the
moderate to severely uncontrolled hypertensive patients, while controlled-hypertensive, mildly uncontrolled
hypertensive showed statistically insignificant changes which indicates that, it is acceptable to continue using
Ranibizumab in both normotensive and hypertensive patients in the short term.