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An IOP increase of \u2265\u200925 mmHg was classified as pathological. We analyzed the incidence rates, the timing of the IOP increase during the administered therapy and the thickness of the retinal nerve fiber and ganglion cell layer over two years in eyes with IOP increase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 50 eyes (1.9%) from 48 patients experienced an increase in IOP during anti-VEGF therapy. In 15 eyes, the increase was attributable to other ocular diseases (such as neovascular glaucoma, uveitis, or endophthalmitis), and these eyes were therefore excluded from further analysis. In contrast, 35 eyes (1.3%) from 33 patients with an average age of 68.4\u2009\u00b1\u200910,0 years, developed an unexplained increase in IOP up to an average of 27 [25\u201345] mmHg, typically after 12 [1\u201335] weeks. 97% of the affected eyes had no history of glaucoma. The baseline IOP was 16 [12\u201320] mmHg. In 24 eyes (68%), short-term topical therapy led to adequate IOP regulation. For 10 eyes (29%) with persistently elevated IOP, continued topical antiglaucoma therapy was required, while 2 eyes required surgical intervention. The average thickness of the retinal nerve fiber layer and the ganglion cell layer did not change significantly over two years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An increased IOP can occur during the course of anti-VEGF therapy in normotensive eyes. This phenomenon can be conservatively controlled in 94% of cases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00417-025-07100-4","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T09:19:39Z","timestamp":1768036779000},"page":"1337-1343","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Unexplained long-term increase in intraocular pressure during the treatment of macular disease with intravitreal anti-VEGF"],"prefix":"10.1007","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4532-7424","authenticated-orcid":false,"given":"Lisa-Marie","family":"Eisenrauch","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaser","family":"Abu-Dail","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristian","family":"Munteanu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elias","family":"Flockerzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berthold","family":"Seitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa Din","family":"Abdin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,10]]},"reference":[{"key":"7100_CR1","doi-asserted-by":"crossref","unstructured":"Flores R, Carneiro \u00c2, Vieira M, Tenreiro S, Seabra MC (2021) Age-related macular degeneration: pathophysiology, management, and future perspectives 244:495\u2013511","DOI":"10.1159\/000517520"},{"key":"7100_CR2","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1016\/S0140-6736(20)31559-2","volume":"396","author":"IU Scott","year":"2020","unstructured":"Scott IU, Campochiaro PA, Newman NJ, Biousse V (2020) Retinal vascular occlusions. 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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"No formal consent is required for this type of study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Financial interests\n                      : Abdin AD has received speaker and consultant honoraria from Roche, Novartis and Bayer Companies. The other authors declare that they have no financial interests.\n                      Non-financial interests\n                      : None","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}