Effect of Acetazolamide on Intraocular Pressure After Intravitreal Injections of Bevacizumab, Triamcinolone Acetonide and Combination of Bevacizumab - Triamcinolone Acetonide

Document Type : Original Article

Authors
Ehsan Namvar
Mohammadkarim Johari
MohammadHosein Nowrouzzadeh
Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
10.22034/pjms.2025.2076514.1258
Abstract
Introduction: Intraocular pressure (IOP) often rises transiently following intravitreal injections as a result of the rapid increase in intraocular volume produced by the injected drug solution. Understanding how to manage this temporary pressure spike is clinically important, particularly for patients with ocular hypertension. The present study was designed with the aim of examining a larger number of patients compared to previous similar studies, in order to more precisely investigate the effect of oral acetazolamide in preventing intraocular pressure increase resulting from intraocular injections.
Methods: This study was a cross-sectional descriptive study conducted in Dastgheib hospital and Poostchi ophthalmology clinic in 2023, which included a total of 1,073 patients aged 18 to 82 years. Of these, 479 patients received an oral acetazolamide tablet one hour prior to the intraocular injection, while 594 patients did not receive any medication before injection.
Results: The analysis revealed that pre-injection administration of oral acetazolamide did not result in a statistically significant or lasting reduction in IOP after intravitreal injection, and its observed effect was minimal and short-term.
Conclusion: Administration of oral acetazolamide before intravitreal injections seem to offer little clinical advantage in preventing transient or sustained IOP increases. Considering its limited efficacy, potential side effects, and additional cost, routine pre-injection use of this medication may not be warranted in standard ophthalmic practice.
Keywords
Acetazolamide
increased intraocular pressure
intravitreal injection &‌‌‌‌‌‌‌‌‌‌ndash
bevacizumab
triamcinolone acetonide
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