Conflict/competing interest: Drs Guymer and Wong are on advisory boards of Novartis and Pfizer and have received research funding, speaking fees, travel and accommodation from either/both companies. Drs Wickremasinghe's and Kawasaki's scholarships are supported by Novartis.
Retinal venular calibre dilatation after intravitreal ranibizumab treatment for neovascular age-related macular degeneration
Article first published online: 18 AUG 2011
© 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists
Clinical & Experimental Ophthalmology
Volume 40, Issue 1, pages 59–66, January/February 2012
How to Cite
Wickremasinghe, S. S., Guymer, R. H., Wong, T. Y., Kawasaki, R., Wong, W. and Qureshi, S. (2012), Retinal venular calibre dilatation after intravitreal ranibizumab treatment for neovascular age-related macular degeneration. Clinical & Experimental Ophthalmology, 40: 59–66. doi: 10.1111/j.1442-9071.2011.02613.x
Funding sources: This study was partially funded by a National Health and Medical Research Council (NHMRC) grant, 52993.
- Issue published online: 5 FEB 2012
- Article first published online: 18 AUG 2011
- Accepted manuscript online: 13 JUN 2011 11:52AM EST
- Received 11 January 2011; accepted 15 May 2011.
- age-related macular degeneration (AMD);
- choroidal neovascularization;
Background: To describe the changes in retinal vascular calibre in response to intravitreal ranibizumab injections in patients with neovascular age-related macular degeneration.
Design: Prospective interventional case series.
Participants: Treatment naïve patients with neovascular age-related macular degeneration were recruited over a 1-year period.
Methods: Each patient received three monthly intravitreal injections according to a ‘loading dose’. Retinal arteriolar and venular calibre was measured from digital fundus photographs and summarized as central retinal artery equivalent and central retinal vein equivalent at baseline and 3 months.
Main Outcome Measure: Central retinal artery equivalent and central retinal vein equivalent changes from baseline to 3 months.
Results: Seventy-four eyes of 71 patients had good quality images for grading vessel calibre at baseline and at 3 months in treated (study) eyes and 51 eyes of 51 patients had good quality images in fellow (control) eyes. Over 3 months, in study eyes treated with ranibizumab, there was a significant increase in central retinal vein equivalent over baseline (+6.20 µm, P = 0.005), but no significant change in central retinal artery equivalent (+0.86 µm, P = 0.55). In control eyes, there was no change in central retinal vein equivalent (−0.82 µm, P = 0.70) or central retinal artery equivalent (0.34 µm, P = 0.75).
Conclusion: Intravitreal ranibizumab has a significant vasodilational effect on retinal venular calibre in eyes treated for neovascular age-related macular degeneration. The reason for this change is unclear, but may relate to changes in blood flow or inflammatory changes within the retina.