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Oculocardiac Reflex During Intravitreal Injection
Miguel Paciuc-Beja1, Daniela Meizner-Grezemkovsky2, Mario Paciuc3
1Ophthalmology Department, Centro Medico ABC, Av Carlos Fernandez Graef, Mexico City, Mexico.
Summary
Oculocardiac reflex (OCR) can occur during intravitreal injections (IVI), affecting 3.3% of patients. This reflex, a significant heart rate decrease, was asymptomatic in the studied population undergoing IVI for common eye conditions.
Area of Science:
- Ophthalmology
- Cardiology
- Clinical Research
Background:
- The oculocardiac reflex (OCR) is a known phenomenon associated with ocular manipulation.
- However, OCR during intravitreal injections (IVI) has not been previously reported, potentially due to lack of heart rate monitoring.
Purpose of the Study:
- To investigate the occurrence and characteristics of the oculocardiac reflex (OCR) during intravitreal injections (IVI).
Main Methods:
- A prospective study involving 532 patients undergoing IVI for diabetic retinopathy, age-related macular degeneration, or choroidal neovascularization.
- Heart rate was continuously monitored using a pulse oximeter before, during, and after the IVI procedure.
- OCR was defined as a ≥20% decrease in heart rate from baseline.
Main Results:
- Oculocardiac reflex (OCR) occurred in 18 patients (3.3%) during intravitreal injection (IVI).
- The observed OCR events were asymptomatic.
- The 95% confidence interval for OCR occurrence was 1.85% to 4.92%.
Conclusions:
- Oculocardiac reflex (OCR) is an underreported event during intravitreal injections (IVI).
- Clinicians should consider the potential for OCR in patients undergoing IVI, even if asymptomatic.
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