Evaluation of intraocular pressure and mean ocular perfusion pressure changes following intravitreal anti-VEGF injections

Abstract

Objective

To evaluate changes in intraocular pressure (IOP) and mean ocular perfusion pressure (MOPP) following intravitreal anti-VEGF injections (IVI) and to assess influencing factors.

Methods

In a prospective study, 119 eyes received anti-VEGF IVI, with 60 eyes treated in the supine position and 59 eyes in the seated position. IOP was assessed using an iCare IC200 rebound tonometer before, immediately after, and at 5 and 30 min post-injection. MOPP was calculated at the same time points. Ocular biometric and demographic data were collected to analyze their impact on IOP changes.

Results

IOP increased from 15.76 ± 4.34 mmHg at baseline to 49.79 ± 15.73 immidiately post-IVI, then decreased to 29.96 ± 10.55 at 5 min and 21.80 ± 7.36 at 30 min. MOPP dropped from 54.02 ± 10.7 mmHg to 35.7 ± 19.7 mmHg immediately post-IVI, recovering to 40.68 ± 15.9 at 5 min and 51.08 ± 12.2 at 30 min. Supine patients exhibited higher IOP, but maintained higher MOPP compared to seated patients. Only 25% of glaucoma patients returned to baseline IOP within 30 min, compared to 48.9% of non-glaucomatous patients (p = 0.02). Phakic patients have greater IOP changes across time, with significant differences at 5 min (p = 0.03).

Conclusion

IVI induced IOP increases and MOPP decreases are significant but normalized to baseline +2SD within 30 min in 67.77% and 97.52% of patients. Glaucomatous and phakic patients are at higher risk for prolonged IOP elevation, requiring careful management.