Effect of intravitreal ranibizumab on the ocular circulation of the untreated fellow eye

Sugimoto, Masahiko; Nunome, Takayasu; Sakamoto, Rie; Kobayashi, Maki; Kondo, Mineo

doi:10.1007/s00417-017-3692-z

Cited by 14 publications

(18 citation statements)

References 45 publications

(42 reference statements)

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“…ese results are in agreement with data reported from other studies [12,13] confirming the reduction of MBR of ONH in diabetic eyes after IVR and results of ocular circulation changes after IVR in other retinal diseases such as RVO describing a reduction of MBR of ONH and of RFV of retinal peripapillary vessels.…”

Section: Discussionsupporting

confidence: 93%

“…Sugimoto et al have assessed the effects of unilateral IVR on the ocular circulation of patients treated for DME and ME in RVO eyes [13]. ey showed a reduction of the MBR of the optic head and of CMT after treatment in the affected treated eyes, but not the fellow untreated eyes.…”

Section: Discussionmentioning

confidence: 99%

“…e systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at the upper arm with a sphygmomanometer before and after each examination. e mean arterial pressure (MAP) was calculated as MAP � DBP + 1/3 (SBP − DBP), and the ocular perfusion pressure (OPP) was calculated as OPP � 2/3 MAP − IOP [13].…”

Section: Systemic Hemodynamicsmentioning

confidence: 99%

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Changes in Ocular Blood Flow after Ranibizumab Intravitreal Injection for Diabetic Macular Edema Measured Using Laser Speckle Flowgraphy

Toto

Evangelista

Viggiano

et al. 2020

BioMed Research International

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Purpose. To evaluate the effects of intravitreal ranibizumab (IVR) treatment on the blood flow of the optic nerve head (ONH) and of retinal vessels of the peripapillary region of eyes with diabetic macular edema (DME) assessed using laser speckle flowgraphy (LSFG). Methods. Forty eyes of 30 patients treated with IVR for DME were included in this prospective clinical study. Mean blur rate (MBR) and relative flow volume (RFV) of the ONH and of a superior retinal artery and an inferior retinal vein of the peripapillary region were measured using LSFG at baseline, 2 weeks (T1), and 1 month (T2) after IVR injection. In addition, best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were measured in all cases. Results. The BCVA improved and CRT decreased significantly during the follow-up period (p<0.010). MBR-related parameters of the ONH such as MBR of all area (MA), MBR of vascular area (MV), and MBR of tissue area (MT) decreased significantly at 2 weeks after IVR compared to baseline values (MA, p=0.046; MT, p=0.023; MV, p=0.025), with no significant change at T2 compared to T1. MBR of the retinal artery and vein changed significantly at 2 weeks after IVR and did not change significantly thereafter (p=0.004 and p=0.01, respectively). The median of RFV of the 2 vessels was 269.5 (221.6–285.5) and 306.8 (285.6–372.4) at baseline and 199.7 (152.4–204.7) and 259.1 (140.9–336.8) at 4 weeks, respectively (p=0.292 and p=0.002, respectively). Blowout time changed significantly in ONH from 47.6 (44.2–50.2) at baseline to 54.4 (46.8–65.3) at 1 month after IVR (p=0.001). Conclusion. IVR injection leads to a reduction of ocular blood flow both in the ONH and in the retinal peripapillary vessels associated with peripapillary vessel constriction. The reduction of CRT and related improvement of vision may be related to the changes in ocular blood flow.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Changes in Ocular Blood Flow after Ranibizumab Intravitreal Injection for Diabetic Macular Edema Measured Using Laser Speckle Flowgraphy

Toto

Evangelista

Viggiano

et al. 2020

BioMed Research International

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“…This result is in agreement with results published on ranibizumab in patients with DME or BRVOME (Sugimoto et al. ).…”

Section: Discussionsupporting

confidence: 93%

“…; Sugimoto et al. ) induce alterations in ocular perfusion with sustained vasoconstrictive effects reported for up to 1 year after administration of the drug. The understanding of potential mid‐ and long‐term vasoconstrictive side‐effects with consequent chronic ocular hypoperfusion and potentially harmful structural or functional changes to the neurosensory retina and/or the ONH is yet to be established.…”

Section: Introductionmentioning

confidence: 99%

Short‐term effect on the ocular circulation induced by unilateral intravitreal injection of aflibercept in age‐related maculopathy

Mursch‐Edlmayr

Luft

Podkowinski

et al. 2019

Acta Ophthalmologica

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Purpose Intravitreal injection of anti‐vascular endothelial growth factor (anti‐VEGF) is the standard treatment for neovascular age‐related macular degeneration (AMD). As VEGF is a physiological key player for regulating retinal vascular tone, questions have been raised whether the application of anti‐VEGF could induce alterations in ocular perfusion. Methods The study included 20 eyes from 20 Caucasian patients with unilateral neovascular AMD and 20 fellow eyes. All eyes were treated with standard intravitreal injection of aflibercept (IVA). Measurements of blood flow at the optic nerve head (ONH) and the choroid were performed with laser speckle flowgraphy (LSFG). The intraocular pressure (IOP), systolic and diastolic blood pressure, heart rate, mean arterial pressure (MAP) and ocular perfusion pressure (OPP) were analysed. Measurements were performed at baseline and repeated immediately after the injection and 30 and 45 min later. Results Mean time between injection of aflibercept and first follow‐up was 8:56 ± 4:25 min. The injection led to significant rise in IOP. In the injected eyes, mean blur rate (MBR, i.e. a relative measure of perfusion and the main outcome parameter of LSFG) within the major vessels of the ONH as well as at the entire ONH region decreased significantly (p < 0.001). No change in MBR was observed in the fellow eye. Choroidal blood flow was maintained stable in both eyes. Conclusion Intravitreal injection of aflibercept (IVA) led to a short‐term reduction in perfusion only in the treated eye. This was independent from IOP, indicating a direct pharmacological effect. No changes in choroidal perfusion were observed during the first 45 min after the injection.

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Changes in vessel density patterns assessed with OCTA in patients with diabetic macular edema treated with anti-VEGF therapy

Santamaría,

Cobos,

Biarnes

et al. 2024

Acta Diabetol

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Aims To determine the presence of sectoral changes in vessel density (VD) patterns induced by vascular endothelial growth factor inhibitors (anti-VEGF) in patients with diabetic macular edema (DME) using optical coherence tomography angiography (OCTA). Methods Prospective, interventional study. A total of 43 patients (63 eyes) were initially enrolled in the study. We performed swept source (SS) OCT and sectorial OCTA measurement to determine parafoveal VD at baseline and after six months of anti-VEGF treatment. In the locations with statistically significant differences in VD between baseline and month 6, we performed univariate and multivariate analyses to determine which, if any, of the baseline variables were associated with the observed changes. Results A total of 34 patients (48 eyes) were included in the final analysis. Mean VD decreased from baseline to month 6 (from 45.2 (± 3.5) to 44.6 (± 3.2) % in the SCP and from 50 (± 3.3) to 49 (± 3.9) % in the DCP). The only significant changes in VD were observed in the nasal sector of the deep capillary plexus, with a decrease of 2.9% (p = 0.001). On univariate and multivariate analyses, the only variable significantly associated with changes in VD in the nasal sector after 6 months of treatment was baseline VD in the same sector. Conclusions Anti-VEGF therapy has a small impact on VD values over time. These variations observed after treatment seems to be related to changes over areas of vascular anomalies and displaced vessels adjacent to cystic areas, with no significant changes over ischemic areas. No correlation was observed between this trend and other clinical baseline features.

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Effect of intravitreal ranibizumab on the ocular circulation of the untreated fellow eye

Cited by 14 publications

References 45 publications

Changes in Ocular Blood Flow after Ranibizumab Intravitreal Injection for Diabetic Macular Edema Measured Using Laser Speckle Flowgraphy

Changes in Ocular Blood Flow after Ranibizumab Intravitreal Injection for Diabetic Macular Edema Measured Using Laser Speckle Flowgraphy

Short‐term effect on the ocular circulation induced by unilateral intravitreal injection of aflibercept in age‐related maculopathy

Changes in vessel density patterns assessed with OCTA in patients with diabetic macular edema treated with anti-VEGF therapy

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