Long-term Impact of Intravitreal Injections on the ocular surface; a 2-year follow-up study

Area of Science:

• Ophthalmology
• Ocular Surface Disease
• Medical Treatments

Background:

• Intravitreal injection (IVI) therapy is a common intraocular procedure.
• Topical povidone-iodine (PVP-I) is the standard antiseptic before IVI.
• PVP-I may cause cytotoxic effects on the ocular surface.

Purpose of the Study:

• To evaluate the long-term impact of serial anti-VEGF IVI on ocular surface parameters.
• To assess changes in tear meniscus height (TMH), bulbar redness (BR), and meibomian gland (MG) loss.
• To compare outcomes between treated eyes and untreated fellow eyes.

Main Methods:

• Prospective study of neovascular age-related macular degeneration (nAMD) patients receiving unilateral IVI.
• Ocular surface parameters (TMH, BR, MG loss) assessed over a two-year interval.
• Comparison between treated eyes and fellow eyes using statistical tests.

Main Results:

• Treated eyes showed significantly less bulbar redness (BR) compared to untreated fellow eyes.
• Untreated eyes exhibited a significant increase in BR over two years.
• Tear meniscus height (TMH) increased significantly in untreated eyes but not in treated eyes.

Conclusions:

• Repeated intravitreal anti-VEGF injections with PVP-I antisepsis led to reduced ocular redness compared to untreated eyes.
• Potential mechanisms include PVP-I's effect on the ocular microbiome or anti-VEGF's antiangiogenic properties.
• Both treated and untreated eyes showed meibomian gland loss, with no significant difference between them.