To determine the effect of intravitreal bevacizumab on retrobulbar blood flow of patients with diabetic macular edema.
Methods
Peak systolic velocity, end-diastolic velocity, resistance, and pulsatility indices of central retinal artery (CRA), nasal posterior ciliary artery (NPCA), temporal posterior ciliary artery (TPCA), and ophthalmic artery (OA) were assessed by color Doppler ultrasonography in injected and uninjected eyes of 37 patients at baseline and at day 1 and day 7 after the injection.
Results
At day 1 after the injection, peak systolic and end diastolic velocities of the CRA and NPCA in the injected eyes and peak systolic velocity of NPCA in the uninjected eyes decreased significantly (p<0.05, p = 0.025, respectively). Peak systolic and end diastolic velocities were not significantly different in the injected and uninjected eyes at day 7 after the injection (p>0.05). In the injected eyes, there was no significant change in resistance and pulsatility indices (p>0.05), but a decrease in resistance index of NPCA and resistance and pulsatility indices of TPCA occurred in uninjected eyes at day 7 after the injection (p = 0.016, p = 0.023, and p = 0.025, respectively).
Conclusions
Intravitreal bevacizumab affects retrobulbar blood flow in injected and uninjected eyes of patients with diabetic macular edema.
StefaniniF.R.ArevaloJ.F.MaiaM.. Bevacizumab for the management of diabetic macular edema. World J Diabetes.2013; 4: 19–26.
4.
PershingS.EnnsE.A.MatesicB.OwensD.K.Goldhaber-FiebertJ.D.. Cost-effectiveness of treatment of diabetic macular edema. Ann Intern Med.2014; 160: 18–29.
5.
MushtaqB.CrosbyN.J.DimopoulosA.T.. Effect of initial retinal thickness on outcome of intravitreal bevacizumab therapy for diabetic macular edema. Clin Ophthalmol.2014; 8: 807–12.
6.
CheemaH.R.Al HabashA.Al-AskarE.. Improvement of visual acuity based on optical coherence tomography patterns following intravitreal bevacizumab treatment in patients with diabetic macular edema. Int J Ophthalmol.2014; 7: 251–5.
7.
ManousaridisK.TalksJ.. Macular ischaemia: a contraindication for anti-VEGF treatment in retinal vascular disease?Br J Ophthalmol.2012; 96: 179–84.
8.
GoelN.KumarV.GhoshB.. Ischemic maculopathy following intravitreal bevacizumab for refractory diabetic macular edema. Int Ophthalmol.2011; 31: 39–42.
9.
FurinoC.BosciaF.CardasciaN.AlessioG.SborgiaC.. Hemorrhagic macular infarction after intravitreal bevacizumab for central retinal vein occlusion. Ophthalmic Surg Lasers Imaging.2010; 9: 1–2.
10.
GanssaugeM.WilhelmH.Bartz-SchmidtK.U.AisenbreyS.. Non-arteritic anterior ischemic optic neuropathy (NA-AION) after intravitreal injection of bevacizumab (Avastin) for treatment of angioid streaks in pseudoxanthoma elasticum. Graefes Arch Clin Exp Ophthalmol.2009; 247: 1707–10.
11.
HosseiniH.RazeghinejadM.R.. Anterior ischemic optic neuropathy after intravitreal injection of bevacizumab. J Neuroophthalmol.2009; 29: 160–1.
12.
HuangZ.L.I.LinK.H.LeeY.C.SheuM.M.TsaiR.K.. Acute vision loss after intravitreal injection of bevacizumab (Avastin) associated with ocular ischemic syndrome. Ophthalmologica.2010; 224: 86–9.
13.
KimK.S.ChangH.R.SongS.. Ischaemic change after intravitreal bevacizumab (Avastin) injection for macular oedema secondary to non-ischaemic central retinal vein occlusion. Acta Ophthalmol.2008; 86: 925–7.
YokoyamaK.ChoshiT.KimotoK.ShinodaK.NakatsukaK.. Retinal circulatory disturbances following intracameral injection of bevacizumab for neovascular glaucoma. Acta Ophthalmol.2008; 86: 927–8.
16.
FungA.E.RosenfeldP.J.ReichelE.. The International Intravitreal Bevacizumab Safety Survey: using the internet to assess drug safety worldwide. Br J Ophthalmol.2006; 90: 1344–9.
17.
SolimanW.VintenM.SanderB.. Optical coherence tomography and vessel diameter changes after intravitreal bevacizumab in diabetic macular oedema. Acta Ophthalmol.2008; 86: 365–71.
18.
GoodT.J.KimuraA.E.MandavaN.KahookM.Y.. Sustained elevation of intraocular pressure after intravitreal injections of anti-VEGF agents. Br J Ophthalmol.2011; 95: 1111–4.
19.
DimitrovaG.KatoS.TamakiY.. Choroidal circulation in diabetic patients. Eye.2001; 15: 602–7.
20.
SulluY.HamidovaR.BedenU.YakupovK.CanbazS.DanaciM.. Effects of pars plana vitrectomy on retrobulbar haemodynamics in diabetic retinopathy. Clin Experiment Ophthalmol.2005; 33: 246–51.
21.
LiebW.E.CohenS.M.MertonD.A.ShieldsJ.A.MitchellD.G.GoldbergB.B.. Color Doppler imaging of the eye and orbit. Technique and normal vascular anatomy. Arch Ophthalmol.1991; 109: 527–31.
22.
RibeiroJ.A.MessiasA.JorgeR.. Antiangiogenic drugs and advanced proliferative diabetic retinopathy. Arq Bras Oftalmol.2011; 74: 143–6.
EhrlichR.CiullaT.A.MossA.M.HarrisA.. Combined treatment of intravitreal bevacizumab and intravitreal triamcinolone in patients with retinal vein occlusion: 6 months of follow-up. Graefes Arch Clin Exp Ophthalmol.2010; 248: 375–80.
25.
HsuJ.KaiserR.S.SivalingamA.. Intravitreal bevacizumab (Avastin) in central retinal vein occlusion. Retina.2007; 27: 1013–9.
26.
ScappaticciF.A.SkillingsJ.R.HoldenS.N.. Arterial thromboembolic events in patients with metastatic carcinoma treated with chemotherapy and bevacizumab. J Natl Cancer Inst.2007; 99: 1232–9.
27.
TatlιpιnarS.DinçU.A.YenerelN.M.GörgünE.. Short-term effects of a single intravitreal bevacizumab injection on retinal vessel calibre. Clin Exp Optom.2012; 95: 94–8.
28.
ChenE.HsuJ.ParkC.H.. Acute visual acuity loss following intravitreal bevacizumab for diabetic macular edema. Ophthalmic Surg Lasers Imaging.2009; 40: 68–70.
29.
KambaT.McDonaldD.M.. Mechanisms of adverse effects of anti-VEGF therapy for cancer. Br J Cancer.2007; 96: 1788–95.
30.
DonatiG.PournarasC.J.MunozJ.L.PoitryS.Poitry-YamateC.L.TsacopoulosM.. Nitric oxide controls arteriolar tone in the retina of the miniature pig. Invest Ophthalmol Vis Sci.1995; 36: 2228–37.
31.
WeiW.ChenZ.W.YangQ.. Vasorelaxation induced by vascular endothelial growth factor in the human internal mammary artery and radial artery. Vascul Pharmacol.2007; 46: 253–9.
32.
BaffertF.LeT.SenninoB.. Cellular changes in normal blood capillaries undergoing regression after inhibition of VEGF signaling. Am J Physiol Heart Circ Physiol.2006; 290: H547–59.
33.
ShimomuraY.HirataA.IshikawaS.OkinamiS.. Changes in choriocapillaris fenestration of rat eyes after intravitreal bevacizumab injection. Graefes Arch Clin Exp Ophthalmol.2009; 247: 1089–94.
ZacharyI.. Signaling mechanisms mediating vascular protective actions of vascular endothelial growth factor. Am J Physiol Cell Physiol.2001; 280: C1375–86.
36.
MatsuyamaK.OgataN.MatsuokaM.WadaM.TakahashiK.NishimuraT.. Plasma levels of vascular endothelial growth factor and pigment epithelium-derived factor before and after intravitreal injection of bevacizumab. Br J Ophthalmol.2010; 94: 1215–8.
37.
WuL.EvansT.. [Immediate changes in intraocular pressure after an intravitreal injection of 2.5 mg of bevacizumab.]Arch Soc Esp Oftalmol.2010; 85: 364–9.
38.
HollandsH.WongJ.BruenR.CampbellR.J.SharmaS.GaleJ.. Short-term intraocular pressure changes after intravitreal injection of bevacizumab. Can J Ophthalmol.2007; 42: 807–11.
39.
TokluY.CakmakH.B.RazaS.AnayolA.AsikE.SimşekS.. Short-term effects of intravitreal bevacizumab (Avastin®) on retrobulbar hemodynamics in patients with neovascular age-related macular degeneration. Acta Ophthalmol.2011; 89: e41–5.
40.
HosseiniH.LotfiM.EsfahaniM.H.. Effect of intravitreal bevacizumab on retrobulbar blood flow in injected and uninjected fellow eyes of patients with neovascular age-related macular degeneration. Retina.2012; 32: 967–71.
