Retinal venular calibre dilatation after intravitreal ranibizumab treatment for neovascular age-related macular degeneration

Authors

  • Sanjeewa S Wickremasinghe FRANZCO,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Robyn H Guymer PhD FRANZCO,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Tien Y Wong PhD FRANZCO,

    Corresponding author
    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
    2. Singapore Eye Research Institute, National University of Singapore, Singapore
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  • Ryo Kawasaki PhD MD,

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • Wanling Wong BSc,

    1. Singapore Eye Research Institute, National University of Singapore, Singapore
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  • Salmaan Qureshi FRANZCO

    1. Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
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  • 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.

  • Funding sources: This study was partially funded by a National Health and Medical Research Council (NHMRC) grant, 52993.

Professor Tien Y Wong, Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, Vic. 3002, Australia. Email: twong@unimelb.edu.au

Abstract

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.

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