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

Hoang, Quan V. MD, PhD*,†,‡,§; Jung, Jesse J. MD*,†,‡,§; Mrejen, Sarah MD*,†; Freund, K. Bailey MD*,†,‡,§

doi: 10.1097/IAE.0000000000000039
Original Study

Purpose: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

In a consecutive series of patients with neovascular age-related macular degeneration receiving anti–vascular endothelial growth factor injections, axial length does not seem to be a predictor of transient or sustained intraocular pressure elevation. Postinjection reflux is related to a lower level of transient postinjection intraocular pressure elevation.

*Vitreous-Retina-Macula Consultants of New York, New York, New York;

LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, New York, New York;

Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York; and

§Department of Ophthalmology, New York University Medical Center, New York, New York.

Reprint requests: K. Bailey Freund, MD, Vitreous-Retina-Macula Consultants of New York, 460 Park Avenue, Fifth Floor, New York, NY 10022; e-mail: kbfnyf@aol.com

Supported by the LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, and The Macula Foundation. Financial disclosure received from Genentech (Consultant, Research Support for K.B.F.), Regeneron (Consultant for K.B.F.), and Bayer (Consultant for K.B.F.).

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.