Ultrasound assessment of ocular vascular effects of repeated intravitreal injections of ranibizumab for wet age-related macular degeneration.

Autor: Bonnin P; Sorbonne-Paris-Cité, AP-HP, Lariboisiere hospital, Department of Clinical-Physiology - Functional-Investigations, Paris-Diderot University, Paris, France; Sorbonne-Paris-Cité, INSERM, U965, Paris-Diderot University, Lariboisiere Hospital, Paris, France., Pournaras JA, Makowiecka K, Krivosic V, Kedra AW, Le Gargasson JF, Gaudric A, Levy BI, Cohen YS, Tadayoni R, Massin P
Jazyk: angličtina
Zdroj: Acta ophthalmologica [Acta Ophthalmol] 2014 Aug; Vol. 92 (5), pp. e382-7. Date of Electronic Publication: 2014 Feb 07.
DOI: 10.1111/aos.12356
Abstrakt: Purpose: Determine the effect of repeated intravitreal injections of ranibizumab (0.5 mg; 0.05 ml) on retrobulbar blood flow velocities (BFVs) using ultrasound imaging quantification in twenty patients with exudative age-related macular degeneration treated for 6 months.
Methods: Visual acuity (ETDRS), central macular thickness (OCT), peak-systolic, end-diastolic and mean-BFVs in central retinal (CRA), temporal posterior ciliary (TPCA) and ophthalmic (OA) arteries were measured before, 2 days, 3 weeks and 6 months after the first injection. Patients were examined monthly and received 1-5 additional injections depending on ophthalmologic examination results.
Results: Six months after the first injection, a significant increase in visual acuity 50.9 ± 25.9 versus 44.4 ± 21.7 (p < 0.01) and decrease in mean central macular thickness 267 ± 74 versus 377 ± 115 μm (p < 0.001) were observed compared to baseline. Although mean-BFVs decreased by 16%±3% in CRA and 20%±5% in TPCA (p < 0.001) 2 days after the first injection, no significant change was seen thereafter. Mean-BFVs in OA decreased by 19%±5% at week 3 (p < 0.001). However, the smallest number of injections (two injections) was associated with the longest time interval between the last injection and month 6 (20 weeks) and with the best return to baseline levels for mean-BFVs in CRA, suggesting that ranibizumab had reversible effects on native retinal vascular supply after its discontinuation. Moreover, a significant correlation between the number of injections and percentage of changes in mean-BFVs in CRA was observed at month 6 (R = 0.74, p < 0.001) unlike TPCA or OA.
Conclusion: Ranibizumab could impair the native choroidal and retinal vascular networks, but its effect seems reversible after its discontinuation.
(© 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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