{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T09:01:21Z","timestamp":1767085281781,"version":"3.44.0"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000646","name":"Japan Society for the Promotion of Science London","doi-asserted-by":"publisher","award":["JP21K16893"],"award-info":[{"award-number":["JP21K16893"]}],"id":[{"id":"10.13039\/501100000646","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Purpose<\/jats:title>\n<jats:p>To investigate whether corneal biomechanical parameters measured via Corvis ST can predict acute intraocular pressure (IOP) elevation following intravitreal anti-VEGF injection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Design<\/jats:title>\n<jats:p>Retrospective observational study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Subjects<\/jats:title>\n<jats:p>Forty eyes from patients with neovascular age-related macular degeneration or retinal vein occlusion who underwent anti-VEGF therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Methods<\/jats:title>\n<jats:p>IOP was measured using the Corvis ST immediately before and 10 minutes after injection. The following biomechanical parameters were evaluated: DA Ratio MAX (2mm), biomechanically corrected IOP (bIOP), Peak Distance, Deflection Amplitude Max, Integrated Radius, and Stress-Strain Index (SSI).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Main outcome measures<\/jats:title>\n<jats:p>Acute post-injection IOP elevation (continuous) and IOP spikes \u226510 mmHg (binary).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec006\">\n<jats:title>Results<\/jats:title>\n<jats:p>The mean IOP increased significantly from 14.5\u2009\u00b1\u20093.17 to 24.7\u2009\u00b1\u20097.44 mmHg post-injection (p &lt; 0.0001). IOP spikes \u226510 mmHg occurred in 55% of eyes. On multivariate analysis, higher bIOP (\u03b2 = +1.17, p = 0.048) and lower DA Ratio MAX (\u03b2 = \u20135.40, p = 0.038) were independent predictors of IOP elevation. DA Ratio MAX was the only significant predictor of IOP spikes (OR = 0.70, 95% CI: 0.51\u20130.96, p = 0.035). ROC analysis showed that DA Ratio MAX alone (AUC = 0.739) outperformed bIOP (AUC = 0.607), with the combined model yielding the highest AUC (0.773). A cutoff of DA Ratio MAX \u22644.936 provided 81.8% sensitivity and 42.9% specificity for predicting spikes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec007\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>DA Ratio MAX (2mm), reflecting global ocular compliance, was a significant predictor of acute IOP spikes after anti-VEGF injection. Alongside bIOP, it may be useful for pre-injection risk stratification of pressure-related complications.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330574","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T17:40:26Z","timestamp":1755884426000},"page":"e0330574","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Corneal biomechanical predictors of intraocular pressure elevation after intravitreal anti-VEGF 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