To determine the effect of a single intravitreal ranibizumab injection on retrobulbar circulation in cases with neovascular age-related macular degeneration (AMD).
Methods:
In this prospective and interventional study, 32 patients with neovascular AMD were enrolled. A single intravitreal ranibizumab dose was in only 1 eye per patient. Peak systolic velocity, end-diastolic velocity, resistive index and pulsatility index values in the common carotid artery, ophthalmic artery, central retinal artery, nasal posterior ciliary artery, and temporal posterior ciliary artery in both injected and uninjected healthy fellow eyes were measured using color Doppler ultrasonography at baseline and 1 week and 1 month after the injection of ranibizumab.
Results:
All measurements revealed no statistically significant difference among baseline, first week, and first month after injection measurements for all parameters measured in all arteries in both the injected and uninjected healthy fellow eyes.
Conclusion:
A single intravitreal injection of ranibizumab does not significantly affect on retrobulbar circulation of either the injected or the uninjected healthy fellow eyes with neovascular AMD.
Get full access to this article
View all access options for this article.
References
1.
Schmidt-ErfurthU., MillerJ.W., SickenbergM.et al.Photodynamic therapy with verteporfin for choroidal neovascularization caused by age-related macular degeneration: results of a single treatment in a phase I and II study. Arch. Ophthalmol., 117:1177–1187. 1999.
2.
KleinR., KleinB.E., LintonK.L.Prevalence of age-related maculopathy. The Beaver Dam Eye Study. Ophthalmology, 99:933–943. 1992.
3.
BirdA.C., BresslerN.M., BresslerS.B.et al.An international classification and grading system for age-related maculopathy and age-related macular degeneration. Surv. Ophthalmol., 39:367–374. 1995.
4.
FerrisF.L., FineS.L., HymanL.Age-related macular degeneration and blindness due to neovascular maculopathy. Arch. Ophthalmol., 102:1640–1642. 1984.
5.
KaiserP.K.Antivascular endothelial growth factor agents and their development: therapeutic implications in ocular diseases. Am. J. Ophthalmol., 142:660–668. 2006.
6.
BhisitkulR.B.Vascular endothelial growth factor biology: clinical implications for ocular treatments. Br. J. Ophthalmol., 90:1542–1547. 2006.
7.
RosenfeldP.J., SchwartzS.D., BlumenkranzM.S.et al.Maximum tolerated dose of a humanized anti-vascular endothelial growth factor antibody fragment for treating neovascular age-related macular degeneration. Ophthalmology, 112:1048–1053. 2005.
8.
BonninP., PournarasJ.A.C., LazrakZ.et al.Ultrasound assessment of short-term ocular vascular effects of intravitreal injection of bevacizumab (Avastin(®)) in neovascular age-related macular degeneration. Acta ophthalmol., 88:641–645. 2010.
MeteA., SaygiliO., BayramM., BekirN.Effects of intravitreal bevacizumab (Avastin) therapy on retrobulbar blood flow parameters in patients with neovascular age-related macular degeneration. J. Clin. Ultrasound., 38:66–70. 2010.
11.
HosseiniH., LotfiM., EsfahaniM.H.et al.Effect of intravitreal bevacizumab on retrobulbar blood flow in injected and uninjected fellow eyes of patients with neovascular age-related macular degeneration. Retina., 32:967–971. 2012.
12.
LiebW.E., CohenS.M., MertonD.A.Color Doppler imaging of the eye and orbit: technique and normal vascular anatomy. Arch. Ophthalmol., 109:527–531. 1991.
13.
EricksonS.J., HendrixL.E., MassaroB.M.et al.Color Doppler flow imaging of the normal and abnormal orbit. Radiology, 173:511–516. 1989.
14.
WilliamsonT.H., HarrisA.Color Doppler ultrasound imaging of the eye and orbit. Surv. Ophthalmol., 40:255–267. 1996.
15.
LiebW.E., FlahartyP.M., HoA., SergottR.C.Color Doppler imaging of the eye and orbit: a synopsis of a 400 case experience. Acta Ophthalmol., 70:50–54. 1992.
16.
HarrisA., JoosK., KayM.et al.Acute IOP elevation with scleral suction: effects on retrobulbar haemodynamics. Br. J. Ophthalmol., 80:1055–1059. 1996.
17.
LiebW.E., FlahartyP.M., SergottR.C.et al.Colour Doppler imaging provides accurate assessment of orbital blood flow in occlusive carotid artery disease. Ophthalmology, 98:548–552. 1991.
18.
GherghelD., OrgulS., GugletaK., GekkievaM., FlammerJ.Relationship between ocular perfusion pressure and retrobulbar blood flow in patients with glaucoma with progressive damage. Am. J. Ophthalmol., 130:597–605. 2000.
19.
VingerlingJ.R., DielemansI., BotsM.L., HofmanA., GrobbeeD.E., de JongP.T.Age-related macular degeneration is associated with atherosclerosis. The Rotterdam Study. Am. J. Epidemiol., 142:404–409. 1995.
20.
FriedmanD.S., O'ColmainB.J., MuñozB.et al.Eye Diseases Prevalence Research Group. Prevalence of age-related macular degeneration in the United States. Arch. Ophthalmol., 122:564–572. 2004.
NassifN.A., CenseB., ParkB.H.et al.In vivo high-resolution video-rate spectral-domain optical coherence tomography of the human retina and optic nerve. Opt. Express., 12:367–376. 2004.
StalmansI., SieskyB., ZeyenT., FieuwsS., HarrisA.Reproducibility of color Doppler imaging. Graefes Arch. Clin. Exp. Ophthalmol., 247:1531–1538. 2009.
31.
StalmansI., VandewalleE., AndersonD.R.et al.Use of colour Doppler imaging in ocular blood flow research. Acta Ophthalmol., 89:609–630. 2011.
32.
HarrisA., WilliamsonT.H., MartinB.et al.Test/retest reproducibility of color Doppler imaging assessment of blood flow velocity in orbital vessels. J. Glaucoma., 4:281–286. 1995.
33.
GalassiF., SodiA., UcciF., RenieriG., PieriB., BacciniM.Ocular hemodynamics and glaucoma prognosis: a color Doppler imaging study. Arch. Ophthalmol., 121:1711–1715. 2003.
