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Correlation of ocular rigidity with intraocular pressure spike after intravitreal injection of bevacizumab in exudative retinal disease
  1. Diane N Sayah1,2,
  2. Andrei-Alexandru Szigiato2,
  3. Javier Mazzaferri1,
  4. Denise Descovich1,
  5. Renaud Duval1,2,
  6. Flavio A Rezende1,2,
  7. Santiago Costantino1,2,
  8. Mark R Lesk1,2
  1. 1 Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada
  2. 2 Ophthalmology, University of Montreal, Montreal, Quebec, Canada
  1. Correspondence to Dr Mark R Lesk, Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC H1T 2M4, Canada; lesk{at}


Background/aims To evaluate the non-invasive measurement of ocular rigidity (OR), an important biomechanical property of the eye, as a predictor of intraocular pressure (IOP) elevation after anti-vascular endothelial growth factor (anti-VEGF) intravitreal injection (IVI).

Methods Subjects requiring IVI of anti-VEGF for a pre-existing retinal condition were enrolled in this prospective cross-sectional study. OR was assessed in 18 eyes of 18 participants by measurement of pulsatile choroidal volume change using video-rate optical coherence tomography, and pulsatile IOP change using dynamic contour tonometry. IOP was measured using Tono-Pen XL before and immediately following the injection and was correlated with OR.

Results The average increase in IOP following IVI was 19±9 mm Hg, with a range of 7–33 mm Hg. The Spearman correlation coefficient between OR and IOP elevation following IVI was 0.796 (p<0.001), showing higher IOP elevation in more rigid eyes. A regression line was also calculated to predict the IOP spike based on the OR coefficient, such that IOP spike=664.17 mm Hg·µL×OR + 4.59 mm Hg.

Conclusion This study shows a strong positive correlation between OR and acute IOP elevation following IVI. These findings indicate that the non-invasive measurement of OR could be an effective tool in identifying patients at risk of IOP spikes following IVI.

  • glaucoma
  • imaging
  • intraocular pressure
  • retina
  • treatment medical

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  • Contributors DS, SC and ML designed the study. DS, DD, RD and FAR were involved in data collection. DS, A-AS, JM, SC and ML analysed and interpreted the data. DS and A-AS drafted the first manuscript.

  • Funding This work was supported by the Canadian Institutes of Health Research (grant number 311562, SC and ML); the Natural Sciences and Engineering Research Council of Canada (grant number RGPIN-2016–04227, SC); the Fonds de Recherche en Ophtalmologie de l’Université de Montréal (ML and SC), the Fonds de Recherche du Québec—Santé (SC and DS) and the Glaucoma Research Society of Canada (ML).

  • Competing interests None declared.

  • Patient consent for publication Informed consent was obtained from all participants prior to testing.

  • Ethics approval This study was approved by the Maisonneuve-Rosemont Hospital Institutional Review Board and conformed to the principles of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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