Optic Nerve Head Structural Changes After Intravitreal Injection

Area of Science:

• Ophthalmology
• Retinal Imaging
• Glaucoma Research

Background:

• Intravitreal injections (IVIs) are common treatments for retinal diseases.
• The acute anatomical effects of IVIs on the optic nerve head (ONH) and Bruch's membrane opening (BMO) are not fully understood.
• Understanding these changes is crucial given the ONH's role in glaucoma.

Purpose of the Study:

• To evaluate acute anatomical changes in BMO and ONH pit depth following anti-VEGF IVIs.
• To investigate factors influencing these anatomical changes, including prior injection history.

Main Methods:

• Prospective study of 51 patients receiving anti-VEGF IVIs.
• High-resolution spectral domain optical coherence tomography (OCT) imaging pre- and post-injection.
• Measurement of ONH pit depth and BMO changes.

Main Results:

• A statistically significant average increase in ONH pit depth of 31.57 ± 24.36 μm post-IVI (p < 0.001).
• The number of previous IVIs showed a significant inverse correlation with the change in pit depth (r = -0.369, p = 0.004).
• No significant associations found between other patient variables or IOP elevation and pit depth/BMO changes.

Conclusions:

• Intravitreal injections are associated with a modest acute increase in ONH pit depth.
• Repeated IVIs may have a cumulative effect on ONH structure.
• These structural changes could be relevant to glaucomatous progression, warranting further investigation.