Abstract
Purpose :
Background: Anti-VEGFs are an efficacious treatment for patients with Age-related Macular Degeneration (AMD), Retinal Vein Occlusion (RVO) and Diabetic Retinopathy (DR). Treatment often requires multiple clinic visits over the course of the disease. Previous studies have suggested the potential of anti-VEGFs intravitreal injections (IVIs) to increase intraocular pressure (IOP) both acute and long-term. This increase in IOP could present a risk factor for glaucoma. The Ocular Response Analyzer (ORA) gives biomechanical properties of the cornea such as corneal hysteresis (CH). CH measures the viscoelastic damping of the cornea. Low CH is associated with progressive optic nerve damage and is an independent risk factor for glaucoma.
Purpose: To investigate CH and IOP in patients receiving anti-VEGFs with a diagnosis of AMD, RVO, DR, and healthy controls.
Methods :
This was a cross-sectional study. Patients (>18 y.o.) with a diagnosis of AMD, RVO, DR or healthy controls were recruited. The patients with a retinopathy reported ongoing IVI treatment. Using the ORA, we recorded their IOPg (e.g. Goldman-correlated IOP) and CH prior to intravitreal injection (IVI).
Results :
Participants in each group (N=60 eyes) were as follows: AMD: 21, RVO: 9, DR: 21 and Control: 9. Mean age= 59.3, 24-88 years, 66% women, 56% non-Hispanic white. Past IVIs: 8.47 ± 10 in first 3 groups. Corneal hysteresis was as follows, AMD: 10.79 ± 1.49, RVO: 9.59±2.09, DR: 10.09 ± 2.57, Controls: 11.31 ± 3.53. IOPg per group, AMD: 16.39±4.57, RVO: 18.23±8.19, DR: 14.93±1.15, Control 14.04±3.94. Participants CH and IOP were not different between groups (p>0.05, for both variables), however CH trended lower and IOP trended higher in the groups receiving IVIs.
Conclusions :
We measured single visit CH and IOPg in patients receiving anti-VEGF drugs as a first step. Lower CH in eyes receiving IVIs compared to controls may indicate a higher risk for glaucoma. Greater sample sizes and longitudinal measurements are needed to further determine if anti-VEGF IVIs affect glaucoma progression over time. Future research will also investigate the correlation between number of past injections and CH. Determing the impact of long-term use of IVIs on CH could help better identify patients at risk for glaucoma.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.