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Short‐time effect of intravitreal injections on retinal vascular oxygenation and vessel diameter in patients with diabetic macular oedema or neovascular age‐related macular degeneration
Author(s) -
Mitsch Christoph,
Pemp Berthold,
Pollreisz Andreas,
Gleiss Andreas,
Karst Sonja,
Scholda Christoph,
Sacu Stefan,
SchmidtErfurth Ursula
Publication year - 2020
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.14276
Subject(s) - medicine , ophthalmology , macular degeneration , retinal , ranibizumab , aflibercept , choroidal neovascularization , oxygenation , oxygen saturation , diabetic retinopathy , anesthesia , surgery , bevacizumab , diabetes mellitus , oxygen , endocrinology , chemotherapy , chemistry , organic chemistry
Abstract Purpose To investigate the short‐time effect of intravitreal injections ( IVI ) of the vascular endothelial growth factor inhibitors ranibizumab and aflibercept on retinal arterial and venous oxygen saturation ( SO 2a and SO 2v), arteriovenous oxygen saturation difference ( AVD ) and vessel diameter ( VD a and VD v) in patients with diabetic macular oedema ( DME ) and patients with choroidal neovascularization ( CNV ) due to age‐related macular degeneration. Methods Uncontrolled prospective observational study in 100 eyes. Retinal vessel oxygen saturation and diameters were assessed using a retinal oximeter before and minutes after IVI of ranibizumab or aflibercept. Results 40 eyes with CNV and 34 eyes with DME were included in the analysis. At baseline, SO 2a and SO 2v were significantly higher in DME (p = 0.043 and p = 0.009, respectively). After IVI , SO 2a significantly decreased in CNV and DME eyes by 2.6% (p = 0.016) and 4.6% (p = 0.002) and SO 2v decreased by 14.0% (p = 0.004) and 12.4% (p = 0.017), respectively. However, a significant increase in AVD was only found in CNV (15.7%, p = 0.001). VD a decreased significantly only in DME by 5.7% (p = 0.010). No medication‐specific disease effect was found and vice versa. Conclusions The observed changes can be interpreted as signs of increased metabolic demand during the physiological stress after an IVI . The abnormal arterial constriction and the abolished increase in AVD seen only in eyes with DME indicate an impairment of vascular autoregulation and oxygen distribution and a reduced neuroretinal metabolism in the diabetic retina with a significant impact on inner retinal oxygen consumption shortly after IVI .