INFLUENCE OF AXIAL LENGTH AND POSTINJECTION REFLUX ON SUSTAINED INTRAOCULAR PRESSURE ELEVATION AS A RESULT OF INTRAVITREAL ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY

Abstract

To assess an association of axial length (AL) or postinjection reflux with transient or sustained intraocular pressure (IOP) elevation in patients with neovascular age-related macular degeneration receiving anti-vascular endothelial growth factor injections. One hundred and forty-seven eyes from 74 consecutive patients with neovascular age-related macular degeneration who presented to a single physician over a 2-month period had ALs measured by IOLMaster. Twenty-one patients had preinjection and immediate postinjection IOP measured and immediate reflux assessed. Overall, 9.5% of eyes had been identified with sustained IOP elevation in our previous study. Axial length did not significantly differ between eyes that had (AL, 23.96 ± 0.66 mm; n = 14) and had not experienced sustained IOP elevation (AL, 23.44 ± 1.24 mm; n = 133; P = 0.12, t-test). By linear regression analysis, the relationship between experiencing sustained IOP elevation and AL was not statistically significant (R² = 0.0165; P = 0.121). The relationship between AL and immediate postinjection IOP elevation was also not statistically significant (R² = 0.0001; P = 0.97). Immediate postinjection IOP increase did differ between eyes without reflux (30.2 ± 9.3 mmHg; n = 12) and those with reflux (1.1 ± 7.2; n = 9; P < 0.001). Axial length does not seem to be a predictor of transient or sustained IOP elevation. Repeated trabecular meshwork trauma related to the absence or presence of reflux and immediate postinjection IOP elevation may be a contributing factor.