June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Assessment of a model using ocular rigidity to predict the magnitude of IOP spikes following intravitreal injections
Author Affiliations & Notes
  • Marisse Masis
    Ophthalmology, University of Montreal, Montreal, Quebec, Canada
    Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
  • Diane N Sayah
    Ophthalmology, University of Montreal, Montreal, Quebec, Canada
    Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
  • Javier Mazzaferri
    Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
  • Denise Descovich
    Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
  • Renaud Duval
    Centre Universitaire d'ophtalmologie de l'Université de Montréal de l'Hôpital Maisonneuve-Rosemont, CIUSSS-E, Montreal, Quebec, Canada
    Ophthalmology, University of Montreal, Montreal, Quebec, Canada
  • Flavio Rezende
    Ophthalmology, University of Montreal, Montreal, Quebec, Canada
    Centre Universitaire d'ophtalmologie de l'Université de Montréal de l'Hôpital Maisonneuve-Rosemont, CIUSSS-E, Montreal, Quebec, Canada
  • Santiago Costantino
    Ophthalmology, University of Montreal, Montreal, Quebec, Canada
    Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
  • Mark Lesk
    Ophthalmology, University of Montreal, Montreal, Quebec, Canada
    Maisonneuve-Rosemont Hospital Research Center, Montreal, Quebec, Canada
  • Footnotes
    Commercial Relationships   Marisse Masis, None; Diane Sayah, None; Javier Mazzaferri, None; Denise Descovich, None; Renaud Duval, None; Flavio Rezende, None; Santiago Costantino, None; Mark Lesk, None
  • Footnotes
    Support  - Canadian Institutes of Health Research (grant number 311562, S.C. and M.R.L.) -Natural Sciences and Engineering Research Council of Canada (grant number RGPIN-2016-04227, S.C.) -Fonds de Recherche en Ophtalmologie de l’Université de Montréal (M.R.L. and S.C.) -Fonds de Recherche du Québec - Santé (S.C. and D.N.S.) -Glaucoma Research Society of Canada (M.R.L.)
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 995. doi:
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      Marisse Masis, Diane N Sayah, Javier Mazzaferri, Denise Descovich, Renaud Duval, Flavio Rezende, Santiago Costantino, Mark Lesk; Assessment of a model using ocular rigidity to predict the magnitude of IOP spikes following intravitreal injections. Invest. Ophthalmol. Vis. Sci. 2020;61(7):995.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Therapeutic intravitreal injections (IVI) of anti-vascular endothelial growth factor (VEGF) agents for exudative retinal diseases are common and effective but are also known to lead to signification intraocular pressure (IOP) spikes, which could lead to glaucomatous optic nerve damage. In this study, we assess the accuracy of a model to predict the magnitude of acute IOP elevation following intravitreal injections using a non-invasive measurement of ocular rigidity.

Methods : This is a prospective, cross-sectional study involving subjects with pre-existing retinal conditions requiring treatment with IVI of anti-VEGF.
Ocular rigidity (OR) was assessed by the measurement of the pulsatile choroidal volume change using video-rate optical coherence tomography (OCT) imaging of the choroid and automated segmentation, as well as the pulsatile IOP change using dynamic contour tonometry. IOP was then measured using Tono-Pen XL before and immediately following the injection of Bevacizumab (1.25 mg, 50 microliters). A linear regression model was calculated to predict IOP spikes from the OR coefficient. A second group of subjects was used to test the predictive capability of the model. Those patients underwent non-invasive OR measurement by one observer. The magnitude of IOP spikes was predicted using the model by that same observer. IOP spike measurement using the Tono-Pen XL was carried out by a second, masked observer, and later compared with the predicted value.

Results : Sixteen participants, aged 67±10 years, were recruited in the first group. Baseline IOP was 17±5 mmHg. The average increase in IOP following IVI was 19±5 mmHg. The calculated regression line was IOP spike = 730.33 mmHg.microliter x OR + 2.95 mmHg. The Spearman correlation coefficient between OR and IOP elevation following IVI was 0.810 (p<0.001), showing higher IOP elevation in more rigid eyes.
In the first patient recruited for the second part of the study our model predicted an IOP spike of 9.9mmHg following IVI, while a spike of 10.0 mmHg was actually measured , a difference of only 0.1mmHg. Recruitment for the second part of this study is ongoing.

Conclusions : This study proposed a model to predict the magnitude of IOP spikes following IVI using the OR coefficient and assesses its predictive accuracy. Clinical applications of the measurement of ocular rigidity may be numerous.

This is a 2020 ARVO Annual Meeting abstract.

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