The Change in Intraocular Pressure After Intravitreal Injection of Anti-VEGF

Abstract

Objective: To determine the alteration in intraocular pressure (IOP) following intravitreal injection of anti-VEGF.

Methodology: A prospective observational study was conducted at Sindh Institute of Ophthalmology and Visual Sciences, Hyderabad, from August 2025 to January 2026, on 49 patients who received intravitreal anti-VEGF injection for various retinal conditions. IOP was measured using Goldmann applanation tonometry at baseline, and at defined intervals post-injection including 30 minutes, 24 hours, one week, and at one month following the procedure. Cases with pre-existing glaucoma or ocular hypertension were noted individually. All the relevant data were analyzed using SPSS version 23 at significance level of p<0.05.

Results: Overall average age of participants was 60.29±8.67 years, with a male predominance of 73%. Baseline IOP mean was 14.2 mmHg, which raised significantly to 22.6+8.4 mmHg at 30 minutes post-injection (p<0.001), demonstrating an average acute rise, while returned toward baseline in most of the cases within 24 hours, recording a mean value of 15.8 ± 3.1 mmHg (p>0.05). Subsequently by 24 hours to 1 week, IOP returned to baseline with no clinically meaningful changes (p>0.05), indicating that the acute post-injection IOP elevation is short-lived and self-resolving in most of the patients.

Conclusion: The anti-VEGF intravitreal injections noted to be the safe regardless of causing acute, transient IOP elevation that peaks immediately post-injection and declines sharply within one hour in most cases, subsequently fully normalizing by 24 hours without prolong effects.