Retinal vascular changes following intravitreal ranibizumab injections for neovascular AMD over a 1-year period

Abstract

Purpose To assess retinal vascular calibre changes in eyes with neovascular age-related macular degeneration (AMD), treated with intravitreal anti-vascular endothelial growth factor agents, over a 1-year period and compare any such changes to untreated fellow eyes. Methods Treatment naïve patients with neovascular AMD received three consecutive intravitreal injections of ranibizumab, followed by a pro re nata dosing regimen up to 1 year, with the aim of maintaining a 'fluid-free' macula. Retinal arteriolar and venular calibre was measured from digital fundus photographs at baseline and at three monthly intervals to 1 year, and summarised as central retinal artery equivalent (CRAE) and central retinal venular equivalent (CRVE), respectively. Results A total of 53 injected eyes and 41 fellow, non-injected eyes were analysed. At baseline, there were no differences in retinal vascular calibre between injected and non-injected eyes (mean CRAE (SD) 144.93 (14.07) vs 145.74 (13.10) lm, P ¼ 0.80 and mean CRVE (SD) 216.23 (25.93) vs 219.91 (22.82) lm, P ¼ 0.53). Over a 12-month period, retinal venular calibre dilatation occurred in injected eyes (mean CRVE change þ 5.71 (14.71) lm, P ¼ 0.007), with no change in retinal arterioles, þ 0.69 (14.71) lm, P ¼ 0.68. In noninjected eyes, arteriolar narrowing occurred as a whole, mean CRAE change À 4.20 (7.00) lm, P ¼ 0.001, over 12 months, with a trend for narrowing in venules, À 2.16 (11.56) lm, P ¼ 0.28. In injected eyes, after controlling for covariates, the changes in CRVE over 12 months mirrored improvements in macular thickness, À 0.06 ( À 0.005, À 0.11) lm, P ¼ 0.04, and visual acuity, þ 9.66 ( À 0.30, þ 19.32) lm, P ¼ 0.06. Conclusion Intravitreal ranibizumab significantly dilated retinal venules after a 1-year period.

Ocular pulse amplitude and retinal vessel caliber changes after intravitreal ranibizumab

“…Mendrinos et al have shown retinal arteriolar narrowing with intravitreal ranibizumab treatment, possibly as a result of ischemia [12]. Wickremasinghe et al reported that retinal venular caliber is increased following repeated intravitreal injections of ranibizumab that may be due to anatomic improvement within the macula, relief of ischemia, or restoration of retinal blood flow [11]. In the present study, there was no significant changes in both retinal arteriole and venule diameters following consecutive ranibizumab injections.…”

“…There are several studies assessing retinal vessel alterations in the setting of intravitreal ranibizumab use for neovascular AMD [11][12][13]. It was reported that intravitreal ranibizumab significantly dilates retinal venules and constricts retinal arterioles, although the underlying mechanisms of these changes are unclear [11][12][13].…”

“…Retinal vessel caliber (RVC) might reflect retinal blood flow and can be measured from retinal photographs [11]. There are several studies assessing retinal vessel alterations in the setting of intravitreal ranibizumab use for neovascular AMD [11][12][13].…”

Revisiting visual dysfunctions in schizophrenia from the retina to the cortical cells: A manifestation of defective neurodevelopment

“…At the retinal level, retinoic acid has been shown to up-regulate VEGF which in turns regulates the retinal vascularization (Wang et al, 2014) and also the caliber of the retinal vessel (Wickremasinghe et al, 2012). This could be linked to the recent observation of wider retinal microvessels in SZ patients (Meier et al, 2013).…”

Real-World Effectiveness and Real-World Cost-Effectiveness of Intravitreal Aflibercept and Intravitreal Ranibizumab in Neovascular Age-Related Macular Degeneration: Systematic Review and Meta-Analysis of Real-World Studies

“…1). After review, 24 observations from 23 studies were selected for inclusion in the meta-analysis (7 observations for intravitreally administered aflibercept [12-16, 34, 35] and 17 for RBZ [34,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]) (Appendix 1 in the supplementary material). One study contributed more than one observation because it reported several subgroups, including both intravitreally administered aflibercept and RBZ [34].…”