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Retinal vascular changes following intravitreal ranibizumab injections for neovascular AMD over a 1-year period
Authors:Wickremasinghe S S  Xie J  Guymer R H  Wong T Y  Kawasaki R  Qureshi S
Affiliation:Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
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) μm, P=0.80 and mean CRVE (SD) 216.23 (25.93) vs 219.91 (22.82) μm, P=0.53). Over a 12-month period, retinal venular calibre dilatation occurred in injected eyes (mean CRVE change +5.71 (14.71) μm, P=0.007), with no change in retinal arterioles, +0.69 (14.71) μm, P=0.68. In non-injected eyes, arteriolar narrowing occurred as a whole, mean CRAE change −4.20 (7.00) μm, P=0.001, over 12 months, with a trend for narrowing in venules, −2.16 (11.56) μm, P=0.28. In injected eyes, after controlling for covariates, the changes in CRVE over 12 months mirrored improvements in macular thickness, −0.06 (−0.005, −0.11) μm, P=0.04, and visual acuity, +9.66 (−0.30, +19.32) μm, P=0.06.

Conclusion

Intravitreal ranibizumab significantly dilated retinal venules after a 1-year period.
Keywords:AMD   retinal vasculature   anti-VEGF
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