Changes in Anterior Segment Morphology after Intravitreal Injection of Bevacizumab and Bevacizumab–triamcinolone Acetate Combination

Abstract
Purpose To evaluate the effects of 2 different amounts of commonly used intravitreal agents on anterior segment morphology in conjunction with intraocular pressure (IOP) changes. Methods Two groups of 46 patients who received intravitreal injection of bevacizumab (group 1, 0.05 mL) or bevacizumab–triamcinolone acetate (TA) combination (group 2, 0.1 mL) were included in this prospective study. All patients underwent anterior segment optical coherence tomography (AS-OCT) imaging with Visante OCT and IOP measurement before and at 5 minutes, 1 hour, and 3 hours after injection. Anterior chamber depth (ACD), angle-opening distance (AOD 500-750), trabecular–iris space area (TISA 500-750), and anterior chamber angle (ACA) were measured. Results were compared between groups and measurement time points. Results The mean change in IOP showed significant difference between baseline and first measurements after the injection in group 1 and group 2 (p = 0.012, p = 0.008, respectively). There was a statistically significant difference from baseline in ACD at the first and second measurements in group 2 (p = 0.005, p = 0.018, respectively). All angle parameters showed insignificant decrease from baseline at all measurement time points in both groups (p>0.05 for each). The difference of angle parameters after injection was not statistically significant between the groups (p>0.05 for each). Conclusions Intravitreal injection of bevacizumab (0.05 mL) or bevacizumab-TA combination (0.1 mL) caused a change in anterior segment configuration determined by AS-OCT. The changes in anterior chamber parameters returned to baseline values with the normalization of IOP values after the first few minutes of injection.