Short-Term Intraocular Pressure Trends After Intravitreal Pegcetacoplan Injection

Purpose: To evaluate the short-term intraocular pressure (IOP) response to intravitreal injections (IVI) of 0.1 mL of pegcetacoplan. Methods: A retrospective, cross-sectional study was performed of patients who received IVI of pegcetacoplan for geographic atrophy (GA). The medical record was reviewed for clinical data, including phakic status, axial length, baseline IOP, IOP after IVI, posterior vitreous detachment (PVD) status, and whether or not an anterior chamber (AC) paracentesis was performed. Main outcomes included mean IOP post-IVI and time for IOP to return to less than 60 mm Hg. Results: Eighty-three IVI from 63 eyes of 50 patients were included for analysis. Mean IOP post-IVI was 64 mm Hg (SD, 22 mm Hg, range, 17-89). Forty eyes (63.4%) had IOP greater than 60 mm Hg after injection, but only 4 (6.3%) still had IOP greater than 60 mm Hg at 5 minutes and required an AC paracentesis. Patients with a PVD had a higher IOP post-IVI than patients without a PVD (67.37 mm Hg vs 49.09 mm Hg, respectively; P = .01). There were no significant predictors for IOP greater than 60 mm Hg at 3 minutes. In a subgroup analysis of eyes that received multiple injections, IOP after the baseline injection was predictive of IOP after later injections (β = 0.62, P = .03). Conclusions: In this cohort of patients receiving pegcetacoplan IVI for GA, the initial IOP spike was high, but the majority of patients did not require AC paracentesis for acute IOP control. Eyes that had a PVD or severe IOP response in previous injections tended to have a higher IOP spike after subsequent injections.