Associations between Serial Intravitreal Injections and Dry Eye

Area of Science:

• Ophthalmology
• Retinal Diseases
• Ocular Surface Disease

Background:

• Neovascular age-related macular degeneration (nAMD) is a leading cause of vision loss.
• Anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections (IVIs) are standard treatment for nAMD.
• The impact of serial IVIs on the ocular surface, particularly meibomian glands (MGs), is not fully understood.

Purpose of the Study:

• To investigate the effects of serial IVIs with anti-VEGF on the ocular surface and MGs in nAMD patients.
• To compare outcomes between treated eyes and untreated fellow eyes.

Main Methods:

• Retrospective, controlled, observational study.
• Ninety nAMD patients receiving unilateral IVIs were analyzed.
• Ocular surface and MG examinations were performed post-IVI, with the fellow eye serving as a control.

Main Results:

• Treated eyes showed significantly reduced upper and lower eyelid meibomian gland (MG) loss compared to fellow eyes (P < 0.001).
• Bulbar redness (BR) was reduced (P = 0.017), and tear meniscus height (TMH) increased (P = 0.02) in treated eyes.
• No significant differences were found in noninvasive tear break-up time (NIBUT), tear film osmolarity (TOsm), Schirmer test, corneal staining, fluorescein tear break-up time (TBUT), meibomian gland expressibility (ME), or meibum quality.

Conclusions:

• Serial IVIs with anti-VEGF, combined with preoperative povidone-iodine (PVP-I) asepsis, are associated with reduced MG loss and ocular inflammation.
• This treatment regimen may offer a beneficial effect on the ocular surface in nAMD patients.
• Further research could explore long-term ocular surface health in patients undergoing repeated IVIs.