Incidence and Predictors of Ocular Hypertension After Intravitreal Injection of Bevacizumab Among Patients Attending KCMC Hospital, 2023–2024

OBJECTIVE: This study aimed to evaluate the incidence, patterns, and determinants of ocular hypertension (OH) following Bevacizumab Intravitreal injections for various retinal diseases at KCMC Hospital, Tanzania. METHODS: A prospective cohort study was conducted from August 2023 to July 2024, involving 120 participants. OH was defined as an intraocular pressure (IOP) >21 mmHg or an increase >5 mmHg from baseline. Data on demographics, injection frequency, ocular conditions, and systemic factors were collected. IOP was measured at baseline, immediately post-injection, and at six-week intervals during follow-up. Paired t-tests compared mean IOP differences, and Poisson regression identified associated factors. RESULTS: Participants' median age was 62 years, diabetic macular edema (52.5%) being the most common indication. OH incidence was 15%, significantly associated with the number of injections (adjusted hazard ratio [AHR] 2.17, 95% CI 1.56-3.16, p < 0.001) and history of YAG laser capsulotomy (AHR 0.33, 95% CI 0.12-0.88, p = 0.028). Temporary post-injection IOP spikes normalized within 60 minutes. CONCLUSION: The study revealed a higher incidence of ocular hypertension following Bevacizumab injections compared to other studies. Significant factors included injection frequency and a history of YAG laser capsulotomy, with repeated injections leading to delayed normalization of short term intraocular pressure and increased short term (within an hour) IOP spikes during subsequent visits.