DYNAMIC CHANGES OF THE ANTERIOR CHAMBER ANGLE PRODUCED BY INTRAVITREAL ANTI-VASCULAR GROWTH FACTOR INJECTIONS

To use anterior segment optical coherence tomography (AS-OCT) to evaluate the anterior chamber after intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections.

Preinjection and immediate postinjection AS-OCT images were taken and measurements were compared including angle opening distance (AOD) and trabeculo-iris space area (TISA) at 500 μm and 750 μm from the scleral spur (AOD500, AOD750, TISA500 and TISA750, respectively), and the scleral spur angle.

Twenty-one eyes from 21 patients were studied. There was significant narrowing of the temporal AOD500, AOD750, and temporal angle after injection (P = 0.03, 0.01, and 0.02, respectively). The percentage of narrowing of the nasal TISA500 and TISA750 was significantly greater in phakic versus pseudophakic eyes (P = 0.03 and 0.02, respectively). A higher postinjection IOP was correlated with increased narrowing of the nasal AOD500, TISA500, TISA750, and nasal angle (R = 0.22, 0.28, 0.34 and 0.20; P = 0.03, 0.01, 0.005 and 0.04, respectively) and a smaller preinjection anterior chamber depth in phakic eyes (R = 0.53, P = 0.01).

After an anti-vascular endothelial growth factor injection, there is significant narrowing of the temporal anterior chamber angle in all eyes and increased narrowing of the nasal angle in phakic compared with pseudophakic eyes. Physicians performing intravitreal injections should be aware of these associations as they may contribute to our understanding of prolonged elevation of IOP after injections.