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Effect of intravitreal injections and volume changes on intraocular pressure: clinical results and biomechanical model

  1. Konstantin Kotliar1,
  2. Mathias Maier1,
  3. Svetlana Bauer2,
  4. Nikolaus Feucht1,
  5. Chris Lohmann1,
  6. Ines Lanzl1

Article first published online: 16 JUN 2007

DOI: 10.1111/j.1600-0420.2007.00939.x

Issue

Acta Ophthalmologica Scandinavica

Acta Ophthalmologica Scandinavica

Volume 85, Issue 7, pages 777–781, November 2007

Additional Information

How to Cite

Kotliar, K., Maier, M., Bauer, S., Feucht, N., Lohmann, C. and Lanzl, I. (2007), Effect of intravitreal injections and volume changes on intraocular pressure: clinical results and biomechanical model. Acta Ophthalmologica Scandinavica, 85: 777–781. doi: 10.1111/j.1600-0420.2007.00939.x

Author Information

  1. 1

    Department of Ophthalmology, Technical University of Munich, Munich, Germany

  2. 2

    Department of Hydroelasticity, St. Petersburg State University, St. Petersburg, Russia

*Dr Konstantin Kotliar Augenklinik rechts der Isar Technical University of Munich Ismaninger Strasse 22 81675 Munich Germany Tel: + 49 89 4140 4295 Fax: + 49 89 4140 4858 Email: kotliar@lrz.tu-muenchen.de

Publication History

  1. Issue published online: 18 OCT 2007
  2. Article first published online: 16 JUN 2007
  3. Received on April 20th, 2006. Accepted on March 7th, 2007.

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Keywords:

  • intravitreal injection;
  • intraocular pressure;
  • biomechanical model;
  • triamcinolone

Abstract.

Purpose:  Intravitreal injections are used extensively to treat retinal diseases. Performing an intravitreal injection increases intraocular volume by the amount of fluid brought into the eye. Whether this influences intraocular pressure (IOP) was investigated here.

Methods:  A biomechanical model relying on 3-dimensional elasticity theory was developed to determine the short-term effect of volume changes on IOP. We calculated the effect for intravitreal injections of 0.1 ml in myopic, emmetropic and hyperopic eyes. Our calculations were compared with IOP measurements obtained immediately after intravitreal injection of 4 mg triamcinolone in 0.1 ml solution (IVTA) in 22 patients. Shortly after the measurement had been taken, IOP was reduced by paracentesis.

Results:  Immediately after IVTA, measured IOP was elevated by a mean of 40.6 ± 12.1 mmHg compared with initial pressure (p < 0.001). Measured and calculated IOP were comparable. Eyes with shorter axial length had higher IOP immediately after the injection (p < 0.05).

Conclusions:  The effect of injected volumes on IOP can be calculated with a biomechanical model. Our results show that paracentesis might be recommended when injecting 0.1 ml of a substance to avoid a short-term increase in IOP. As intravitreal injections are mostly applied in diseases that are due to vascular compromise, it might be prudent not to impair perfusion in those eyes, even for short periods of time.

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