Glaucoma Drainage Device Erosions in Patients Receiving Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Retinopathy

Yasmin Florence Khodeja Islam; Elizabeth A Vanner; Arindel S R Maharaj; Stephen G Schwartz; Krishna Kishor

doi:10.2147/OPTH.S386033

Glaucoma Drainage Device Erosions in Patients Receiving Anti-Vascular Endothelial Growth Factor Therapy for Diabetic Retinopathy

Clin Ophthalmol. 2022 Nov 9:16:3681-3687. doi: 10.2147/OPTH.S386033. eCollection 2022.

Authors

Yasmin Florence Khodeja Islam¹, Elizabeth A Vanner¹, Arindel S R Maharaj¹, Stephen G Schwartz¹, Krishna Kishor¹

Affiliation

¹ Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, USA.

Abstract

Purpose: To determine if intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are associated with an increased risk of glaucoma drainage device (GDD) erosions.

Patients and methods: A retrospective chart review was conducted including patients with diabetic retinopathy and had a GDD implanted at a large academic institution. The rate of GDD erosions was compared between eyes that did or did not receive intravitreal anti-VEGF injections. A subanalysis was also performed the relationship between diabetic macular edema (DME) and intravitreal steroid injections and GDD erosions.

Results: A total of 677 eyes from 608 patients was included. A total of 447 eyes received at least one anti-VEGF injection; 230 eyes never received such therapy. Twenty eyes (4.5%) receiving anti-VEGF had at least one erosion event, compared to 7 eyes (3.0%) of patients not receiving anti-VEGF therapy (OR 1.49, p=0.37). Diabetic macular edema was associated with a significantly increased rate of erosion in eyes not receiving anti-VEGF (71.4% versus 31.4%, p=0.034), but not in eyes receiving anti-VEGF (30.0% versus 40.7%, p=0.34). Receiving more than one specific anti-VEGF agent, an increased frequency or total number of anti-VEGF injections, or receiving intravitreal steroids were not associated with an increased risk of erosion (p>0.05).

Conclusion: In patients with diabetic retinopathy, the use of anti-VEGF does not result in an increased rate of GDD erosions or recurrent erosions. Further research is needed over a longer follow-up period to determine if longer or more frequent anti-VEGF treatment is a risk factor for recurrent erosions.

Keywords: anti-vascular endothelial growth factor; diabetic retinopathy; glaucoma drainage device; tube erosion.

Grants and funding

This study was supported by the NIH Center Core Grant P30EY014801 and an unrestricted grant to the University of Miami from the Research to Prevent Blindness.