Corneal Biomechanics as a Predictor of Eye Pressure Rise After Anti-VEGF Injection

What is it about?

When doctors inject anti-VEGF medicine into the eye to treat diseases like age-related macular degeneration, the eye pressure (IOP) often goes up suddenly. Usually this spike is short-lived, but in some people — especially those with glaucoma — it can be risky. Your study asked: Can we predict who will have a big pressure spike before the injection, just by looking at how the cornea (the clear front part of the eye) behaves? To test this, you used a machine called the Corvis ST, which gently pushes on the cornea with an air puff and measures how it bends. This tells us about the eye’s “flexibility” or stiffness. You found that one measure, called DA Ratio MAX, was the strongest predictor. In simple terms: If the cornea deforms less flexibly in the center compared to the edges, the eye is more likely to have a dangerous pressure jump after injection. Another measure, biomechanically corrected IOP (bIOP), also mattered but was less reliable. So, a simple corneal test before the injection may help identify patients at higher risk for pressure problems, guiding doctors to monitor them more closely or take preventive steps.

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Photo by Harry Quan on Unsplash

Photo by Harry Quan on Unsplash

Why is it important?

Anti-VEGF injections are common: Millions of patients worldwide get these injections for macular diseases. Even though the treatment is very effective, pressure spikes in the eye happen almost every time. Pressure spikes can be dangerous: For most people the spike is brief, but in patients with glaucoma or fragile optic nerves, even short bursts of high pressure can damage vision. We need a way to predict risk: Right now, doctors can’t easily tell which patient will have a dangerous spike and which won’t. Anatomy alone (like eye length or lens status) doesn’t explain it well. Corneal biomechanics provide a new tool: This study shows that a simple, quick, non-contact test of corneal flexibility (DA Ratio MAX) can flag patients more likely to have big spikes. Better safety and personalized care: If we can predict risk before injection, doctors could monitor those patients more closely, use preventive pressure-lowering drops, or adjust injection strategy — making treatment safer for everyone. In short: This research matters because it offers a simple way to identify which patients are most at risk of harmful eye pressure spikes during a treatment that millions of people need.

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