Macugen causes worrying IOP spikes

Pegaptanib sodium (Macugen) injections can result in a significant transient rise in intraocular pressure (IOP), which may be damaging to the optic nerve, particularly in patients with advanced glaucoma, according to a study published in the June issue of the American Journal of Ophthalmology.

Ronald Frenkel from the Eye Research Institute and colleagues from the East Florida Eye Institute, Florida, USA conducted a review of 75 eyes treated with intravitreal injections of pegaptanib (0.09 ml).

The mean pre-injection IOP was 14±3 mmHg. At one minute post-injection, mean IOP was 38±14 mmHg, at three to 10 minutes it was 34±9 mmHg and at 11 to 20 minutes it was 26±10 mmHg. Most patients' IOP diminished significantly 30 minutes after the injection.

The authors concluded that this dramatic rise in IOP following injections of pegaptanib could cause damage to the optic nerve, particularly in patients with advanced glaucoma and hence its use in glaucomatous patients should be approached with caution.