Contributing factors to short-term intraocular pressure elevation following intravitreal anti-VEGF injections

Short-term intraocular pressure (IOP) elevation is a common complication following intravitreal injection (IVI) of anti-VEGF drugs, potentially posing risks to retinal health. This study aimed to identify key factors influencing short-term IOP elevation and provide actionable insights for its prediction and effective management in clinical practice.

An observational study was conducted on 64 postoperative measurements from patients who underwent IVI of anti-VEGF drugs at Yidu Central Hospital of Weifang between 2023 and 2024. Data on patient demographics (e.g., age, sex), clinical characteristics (e.g., lens status, diabetes), and pre- and postoperative IOP values were collected. A linear mixed-effects model was applied to evaluate factors associated with IOP elevation 5 min post-injection.

The baseline IOP was 14.64 ± 2.71 mmHg, increasing to 43.33 ± 7.70 mmHg at 5 min post-injection and subsequently decreasing to 19.25 ± 3.80 mmHg at 30 min post-injection. Statistically significant differences were observed between the baseline and postoperative IOP values (p < 0.0001). At 30 min post-injection, 68.8% of the measured IOP values were ≤ 21 mmHg, and all were ≤ 30 mmHg. The linear mixed-effects model revealed that older age (p < 0.001), native crystalline lens (p < 0.001), and diabetes (p = 0.009) were significant predictors of greater IOP elevation at 5 min post-injection.

Short-term IOP elevation following intravitreal anti-VEGF injections is associated with older age, a native crystalline lens, and diabetes. Individualized preventive strategies may effectively mitigate the risk of postoperative IOP elevation in high-risk patients.