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

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.