Optical coherence tomography and Scheimpflug imaging of the iridocorneal angle following intravitreal injection of different medications: A longitudinal analysis

• Published in: Photodiagnosis and photodynamic therapy 2023-03, Vol.41, p.103319-103319, Article 103319
• Main Authors: Hepokur, Mustafa, Ersoy, Esma Ecem, Kısakürek, Berkay, Sali, Fatma, Durmus, Ebubekir, Aykut, Veysel, Oguz, Halit, Esen, Fehim
• Format: Article
• Language: English
• Subjects: Angiogenesis Inhibitors - therapeutic use; Anterior Chamber; Dexamethasone; Humans; Intravitreal implant; Intravitreal injection; Intravitreal Injections; Iridocorneal angle; Longitudinal Studies; Optical coherence tomography; Photochemotherapy - methods; Photosensitizing Agents - pharmacology; Prospective Studies; Tomography, Optical Coherence - methods
• ISSN: 1572-1000; 1873-1597
• DOI: 10.1016/j.pdpdt.2023.103319

•In the literature, immediate iridocorneal angle and IOP changes after intravitreal injections are frequently discussed. However, there is very limited information regarding their long-term effects. This study demonstrated the long-term effects of 3 different intravitreal anti-vascular endothelial growth factors (anti-VEGF) and 1 dexamethasone implant medication on the iridocorneal angle structure.•Steroids are known to alter the microstructure of the trabecular meshwork and cause steroid-responder glaucoma in susceptible patients. In this study, intravitreal dexamethasone implant was the only treatment that was associated with iridocorneal angle widening, while there was no such reproducible change following bevacizumab, ranibizumab, or aflibercept injections.•The currrent study suggests that the widening of the iridocorneal angle due to the dexamethasone implant injection was not associated with change in IOP in the longitudinal analysis.•This study suggest that 3 different anti-VEGF medication and dexamethasone implant injections did not have any influence on the size of ocular eye volume and these medications were not toxic to the corneal endothelium in the longitudinal follow-up. Intravitreal injection of medications induces a sudden increase in posterior segment volume and pushes iris plane anteriorly to narrow iridocorneal angle. The aim of this study to follow and define longitudinal course of these changes following intravitreal injection of 3 different anti-vascular endothelial growth factor (VEGF) medications or dexamethasone implant. This prospective, longitudinal study included 89 eyes of 89 patients that had an intravitreal injection of bevacizumab (n = 20) or ranibizumab (n = 26) or aflibercept (n = 22) or dexamethasone implant (n = 21). All the participants had a detailed ophthalmological examination including anterior segment optical coherence tomography (AS-OCT) and Scheimpflug imaging of the iridocorneal angle, evaluation of anterior chamber depth (ACD), axial length with optical biometry and endothelial cell counts with specular microscopy just before the injection, at post-injection day 1, and post-injection 1st month. Iridocorneal angle became significantly wider following intravitreal injection of dexamethasone implant at nasal and temporal quadrants at the post-injection 1st month both in AS-OCT (p = 0.006, p = 0.002, respectively) and Scheimpflug imaging (p = 0.003, p = 0.004, respectively). Small changes were observed in iridocorn