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Kim, Kim, Kim, Han, Seo, Yoo, Chung, and Park: The Change of Anterior Chamber Parameters with Pentacam® after Intravitreal Injection
Original Article

J Korean Ophthalmol Soc 2013;54(12):1824-1831.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.12.1824

The Change of Anterior Chamber Parameters with Pentacam® after Intravitreal Injection

Byoung Seon Kim, MD1, Che Ron Kim, MD1, Seong Jae Kim, MD1, 2, Yong Seop Han, MD1, 2, Seong Wook Seo, MD, PhD1, 2, Ji Myung Yoo, MD, PhD1, 2, In Young Chung, MD1, 2, Jong Moon Park, MD, PhD1, 2,

1Department of Ophthalmology, Gyeongsang National University School of Medicine, Jinju, Korea

2Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, Korea

Address reprint requests to Jong Moon Park, MD, PhD Department of Ophthalmology, Gyeongsang National University Hospital, #79 Gangnam-ro, Jinju 660-702, Korea, Tel: 82-55-750-8167, Fax: 82-55-758-4158, E-mail: parkjm@gnu.ac.kr

Received 26 April 201326 July 2013       Accepted 29 October 2013

Copyright © 2013 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the changes of anterior chamber parameters and intraocular pressure (IOP) with Pentacam® after intravitreal injection.

Methods

A total of 76 eyes of 76 patients received an intravitreal injection of either triamcinolone acetonide (TA) or bevacizumab. Twelve patients were treated with an intravitreal injection of TA 0.1 ml, 16 patients were treated with an intravitreal injection of TA 0.05 ml, while the remaining 48 patients received a bevacizumab 0.05 ml injection. All patients underwent anterior chamber depth, anterior chamber angle, and anterior chamber volume evaluation with Pentacam® before and 5 minutes after injection. Additionally, IOP measurements were taken 5 minutes before and 5 minutes, 30 minutes, 1 hour and 1 day after injection.

Results

Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving TA 0.1 ml were 0.4 ± 0.11 mm, 10.2 ± 4.1°, 33.7 ± 5.9 mm3 and 18.8 ± 12.1 mm Hg, respectively. Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving TA 0.05 ml were -0.01 ± 0.05 mm, 2.4 ± 3.2°, 5.8 ± 9.5 mm3 and 4.8 ± 7.4 mm Hg, respectively. Anterior chamber depth, anterior chamber angle, anterior chamber volume, and IOP changes in patients receiving bevacizumab were 0.28 ± 0.99 mm, 0.8 ± 4.0°, 7.1 ± 9.6 mm3 and 5.4 ± 6.3 mm Hg, respectively. There was a significant difference between TA 0.1 ml and 0.05 ml. However, there was no significant difference between TA 0.05 ml and bevacizumab 0.05 ml.

Conclusions

Because of similar anterior chamber parameters changes after 0.05 ml intravitreal injection with TA or bevacizumab, early period IOP increases due to intravitreal volume expansion. Intravitreal 0.05 ml injections do not require any other procedures for controlling IOP 30 minutes after injection.

Keywords: Anterior chamber parameters, Intravitreal injection, PentacamⓇ

References

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Figure 1.
Preop (A) and postop (B) Pentacam® images of intravitreal triamcinolon 0.05 ml injection patient.
jkos-54-1824f1.tif
Figure 2.
Preop (A) and postop (B) Pentacam® images of intravitreal triamcinolone 0.1 ml injection patient.
jkos-54-1824f2.tif
Figure 3.
IOP changes in IVTA patients and IVB or IVR patients. Preop (I) = immediate before injection; Postop (I) = immediate after injection; Dash line = IVB patients; Continuous line = IVTA 0.05 ml patients.
jkos-54-1824f3.tif
Table 1.
Patients demographics
  Total patients IVTA 0.1 ml patients IVTA 0.05 ml patients IVB patients p-value*
Number of eyes 76 12 16 48  
Sex         0.201
  Male 38 10 6 22  
  Female 38 2 10 26  
Age (years) 55.5 ± 11.2 57.6 ± 11.5 52.9 ± 10.2 56.2 ± 13.7 0.786
Laterality         0.874
  OD 62 10 12 40  
  OS 14 2 4 8  
Diagnosis          
  AMD 22 0 0 22  
  DMR with ME 40 10 14 16  
  BRVO with ME 9 0 1 8  
  CRVO with ME 5 2 1 2  
Basal IOP (mm Hg) 15.6 ± 2.2 16.3 ± 1.5 15.3 ± 2.1 15.7 ± 2.6 0.708

Values are presented as mean ± SD.

AMD = age related macular degeneration; DMR with ME = diabetic retinopathy with macular edema; BRVO with ME = branch retinal vein occlusion with macular edema; CRVO with ME = central retinal vein occlusion with macular edema; Basal IOP = intraocular pressure of 1 hour before injection; IVTA = intravitreal triamcinolone acetonide injection; IVB = intravitreal bevacizumab injection.

* One-way ANOVA test.

Table 2.
Changes of anterior chamber parameters
  Total patients
 IVTA 0.1 ml patients
 IVTA 0.05 ml patients
 IVB patients
  Pre-injection Post-injection Pre-injection Post-injection Pre-injection Post-injection Pre-injection Post-injection
Corneal thickness 535.3 ± 28.1 566.9 ± 30.1 542.2 ± 18.8 578.2 ± 13.6 535.3 ± 19.8 563.4 ± 23.9 535.7 ± 31.5 569.1 ± 32.9
  p-value* <0.001 0.035 <0.001 <0.001
ACD 2.8 ± 0.5 2.6 ± 0.6 2.7 ± 0.2 2.3 ± 0.2 2.6 ± 0.2 2.6 ± 0.3 2.9 ± 0.8 2.7 ± 0.8
  p-value* 0.022 0.013 0.803 0.200
ACV 147.8 ± 30.1 137.3 ± 31.4 158.8 ± 23.4 125.2 ± 25.1 136.5 ± 15.6 130.6 ± 11.8 146.9 ± 34.3 128.5 ± 50.0
  p-value* 0.001 0.001 0.131 0.145
ACA 29.2 ± 6.3 27.0 ± 6.8 33.6 ± 7.1 23.4 ± 4.8 30.3 ± 2.3 27.9 ± 2.6 28.1 ± 6.4 27.3 ± 7.7
  p-value* 0.009 0.041 0.067 0.322

Values are presented as mean ± SD.

ACD = anterior chamber depth; ACV = anterior chamber volume; ACA = anterior chamber angle; IVTA = intravitreal triamcinolone acetonide injection; IVB = intravitreal bevacizumab injection.

* Student t-test.

Table 3.
Comparison of changes at 5 minutes after intravitreal injection
  IVTA 0.1 ml patients (n = 12) IVTA 0.05 ml patients (n = 16) p-valuev*
△ Corneal Thickness (Pre-Post) -36.0 ± 10.4 -28.1 ± 11.1 0.201
△ ACD (Pre-post) 0.4 ± 0.11 -0.01 ± 0.05 <0.001
△ ACV (Pre-post) 33.7 ± 5.9 5.8 ± 9.5 <0.001
△ ACA (Pre-Post) 10.2 ± 4.1 2.4 ± 3.2 0.002
△ IOP (I) 36.8 ± 10.2 22.1 ± 8.6 0.022
△ IOP (5) 18.8 ± 12.1 4.8 ± 7.4 0.021

Values are presented as mean ± SD.

ACD = anterior chamber depth; ACV = anterior chamber volume; ACA = anterior chamber angle; IOP (I) = IOP difference between immediately post-injection and pre-injection; IOP (5) = IOP difference between 5 minutes post-injection and pre-injection.

* Independent t-test.

Table 4.
Comparison of changes at 5 minutes after intravitreal injection
  IVTA 0.05 ml patients (n = 16) IVB 0.05 ml patients (n = 48) p-value*
△ Corneal Thickness (Pre-Post) -28.1 ± 11.1 -33.0 ± 9.2 0.163
△ ACD (Pre-post) -0.01 ± 0.05 0.10 ± 0.43 0.430
△ ACV (Pre-post) 5.8 ± 9.5 7.1 ± 9.6 0.855
△ ACA (Pre-Post) 2.4 ± 3.2 0.8 ± 4.0 0.288
△ IOP (I) 22.1 ± 8.6 20.7 ± 7.2 0.640
△ IOP (5) 4.8 ± 7.4 5.4 ± 6.3 0.807

Values are presented as mean ± SD.

ACD = anterior chamber depth; ACV = anterior chamber volume; ACA = anterior chamber angle; IOP (I) = IOP difference between immediately post-injection and pre-injection; IOP (5) = IOP difference between 5 minutes post-injection and pre-injection.

* Independent t-test.

Table 5.
Comparison of high IOP (≥21 mm Hg) patients at 5 minutes after intravitreal injection
  IVTA 0.05 ml patients (n = 4) IVB 0.05 ml patients (n = 22) p-value*
△ Corneal thickness (Pre-post) -29.0 ± 5.7 -37.8 ± 11.1 0.309
△ ACD (Pre-post) -0.02 ± 0.02 -0.03 ± 0.07 0.746
△ ACV (Pre-post) -1.5 ± 17.7 11.2 ± 23.5 0.489
△ ACA (Pre-Post) -1.0 ± 5.7 2.3 ± 3.6 0.279
△ IOP (5) 14.5 ± 10.6 11.5 ± 4.8 0.506

Values are presented as mean ± SD.

ACD = anterior chamber depth; ACV = anterior chamber volume; ACA = anterior chamber angle; IOP (5) = IOP difference between 5 minutes post-injection and pre-injection.

* Independent t-test.

Table 6.
Comparison between high IOP (≥21 mm Hg) and normal IOP (<21 mm Hg) patients at 5 minutes after intravitreal injection
  IVTA 0.05 ml patients (n = 16)
 IVB patients (n = 48)
  Normal IOP (n = 12) High IOP (n = 4) p-value* Normal IOP (n = 26) High IOP (n = 22) p-value*
△ Corneal thickness (Pre-post) -27.8 ± 12.8 -29.0 ± 5.7 0.909 -30.2 ± 6.0 -37.8 ± 11.1 0.058
△ ACD (Pre-post) -0.002 ± 0.06 -0.02 ± 0.02 0.790 0.19 ± 0.54 -0.03 ± 0.07 0.238
△ ACV (Pre-post) 8.2 ± 6.0 -1.5 ± 17.7 0.239 4.3 ± 17.1 11.2 ± 23.5 0.393
△ ACA (Pre-Post) 3.6 ± 1.2 -1.0 ± 5.7 0.070 0.1 ± 3.8 2.3 ± 3.6 0.144
△ IOP (5) 1.5 ± 3.1 14.5 ± 10.6 0.001 1.2 ± 2.6 11.5 ± 4.8 0.001

Values are presented as mean ± SD.

ACD = anterior chamber depth; ACV = anterior chamber volume; ACA = anterior chamber angle; IOP (5) = IOP difference between 5 minutes post-injection and pre-injection.

* Independent t-test.

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