Changes in intraocular pressure in study and fellow eyes in the IVAN trial

Alexander J E Foss, Lauren J Scott, Chris A Rogers, Barnaby C Reeves, Faruque Ghanchi, Jonathan Gibson, Usha Chakravarthy, IVAN study group

Research output: Contribution to journalArticle (Academic Journal)peer-review

13 Citations (Scopus)
328 Downloads (Pure)


PURPOSE: To describe changes in intraocular pressure (IOP) in the 'alternative treatments to Inhibit VEGF in Age-related choroidal Neovascularisation (IVAN)' trial (registered as ISRCTN92166560).

DESIGN: Randomised controlled clinical trial with factorial design.

PARTICIPANTS: Patients (n=610) with treatment naïve neovascular age-related macular degeneration were enrolled and randomly assigned to receive either ranibizumab or bevacizumab and to two regimens, namely monthly (continuous) or as needed (discontinuous) treatment.

METHODS: At monthly visits, IOP was measured preinjection in both eyes, and postinjection in the study eye.

OUTCOME MEASURES: The effects of 10 prespecified covariates on preinjection IOP, change in IOP (postinjection minus preinjection) and the difference in preinjection IOP between the two eyes were examined.

RESULTS: For every month in trial, there was a statistically significant rise in both the preinjection IOP and the change in IOP postinjection during the time in the trial (estimate 0.02 mm Hg, 95% CI 0.01 to 0.03, p<0.001 and 0.03 mm Hg, 95% CI 0.01 to 0.04, p=0.002, respectively). There was also a small but significant increase during the time in trial in the difference in IOP between the two eyes (estimate 0.01 mm Hg, 95% CI 0.005 to 0.02, p<0.001). There were no differences between bevacizumab and ranibizumab for any of the three outcomes (p=0.93, p=0.22 and p=0.87, respectively).

CONCLUSIONS: Anti-vascular endothelial growth factor agents induce increases in IOP of small and uncertain clinical significance.


Original languageEnglish
Pages (from-to)1662-1667
Number of pages6
JournalBritish Journal of Ophthalmology
Issue number12
Early online date12 Apr 2016
Publication statusPublished - 1 Dec 2016

Structured keywords

  • BTC (Bristol Trials Centre)
  • Centre for Surgical Research


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