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Observational Study
. 2025 May 7;25(1):281.
doi: 10.1186/s12886-025-04111-x.

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

Yanchen Liu #  1 , Ting Wang #  2 , Xiaohong Zhang  3 , Mengyun Li  1 , Li Han  1 , Xianhai Lan  1 , Li Wang  1 , Xuefeng Wang  4
Affiliations
Observational Study

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

Yanchen Liu et al. BMC Ophthalmol. .

Abstract

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.

Keywords: Anti-VEGF; Diabetes; Intraocular pressure; Intravitreal injection; Pseudophakia.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was reviewed and approved by the Ethics Committee of the Yidu Central Hospital of Weifang (Approval No.YDCH2024-160). All procedures involving human participants were performed in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all individual participants included in the study. Consent for publication: Not applicable. This manuscript does not contain data from any individual person that could be identified. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
IOP at different time points. Bar graph showing IOP at baseline, 5 min, and 30 min post-injection. Error bars show standard error. **** indicates p < 0.0001
Fig. 2
Fig. 2
Effect of age and lens status on IOP elevation. Scatter plot showing age versus IOP elevation 5 min post-injection. Trend lines represent pseudophakic and phakic groups
See this image and copyright information in PMC

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