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Effect of intravitreal bevacizumab and aflibercept on retrobulbar blood flow in injected and uninjected sound eyes of patients with neovascular age‐related macular degeneration
Author(s) -
Sebastiani S.,
Corcioni B.,
Pazzaglia A.,
Gaudiano C.,
Cellini M.,
Golfieri R.,
Campos E.C.
Publication year - 2017
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/j.1755-3768.2017.0f077
Subject(s) - medicine , aflibercept , macular degeneration , ophthalmology , central retinal artery , bevacizumab , blood flow , ophthalmic artery , retinal , choroid , ciliary arteries , surgery , retina , chemotherapy , physics , optics
Purpose To evaluate early changes in retrobulbar blood flow following intravitreal injection of anti‐vascular endothelial growth factor ( VEGF ) agents. Methods Ten patients affected by neovascular age‐related macular degeneration in 1 eye were enrolled. Five eyes received intravitreal bevacizumab (1.25mg/0.05mL) and 5 eyes aflibercept (2mg/0.05mL). Retrobulbar blood flow was examined by color doppler ultrasonography (Aplio 500, Toshiba Medical System, Tokyo, Japan). Peak systolic velocity ( PSV ) and resistivity index ( RI ) was measured from ophthalmic artery ( OA ), central retinal artery ( CRA ) and posterior ciliary artery ( PCA ) in both injected and uninjected sound eyes, before and 21 days after treatment. Results Before and after intravitreal bevacizumab mean retrobulbar blood flow parameters significantly change in PCA : PSV 15.24±3.96 cm/sec vs 12.90±2.63 cm/sec (p=0.0012), RI 0.74±0.02 vs 0.77±0.07 (p=0.009) and in CRA : PSV 14.16±1.8 cm/sec vs 12.29±1.54 cm/sec (p=0.005), RI 0.77±0.03 vs 0.79±0.03 (p=0.029). In the sound fellow eyes, significant changes resulted in PCA : PSV 17.26±3.45 cm/sec vs 13.63±3.3 cm/sec (p=0.003), RI 0.74±0.05 vs 0.79±0.03 (p=0.026). Before and after intravitreal aflibercept measured data significantly change in PCA : PSV 12.8±3.09 cm/sec vs 7.20±0.62 cm/sec (p=0.023), RI 0.68±0.03 vs 0.77±0.03 (p=0.007) and in CRA : PSV 14.28±1.2 cm/sec vs 11.04±0.77 cm/sec (p=0.037), RI 0.73±0.03 vs 0.78±0.05 (p=0.022). In the sound fellow eyes, significant changes resulted in PCA : PSV 12.44±2.89 cm/sec vs 9.18±1.42 cm/sec (p=0.044), RI 0.69±0.05 vs 0.75±0.02 (p=0.028). Conclusions Intravitreal injections of bevacizumab and aflibercept significantly reduce ocular hemodynamic parameters both in treated and in untreated eyes. These evidences suggest a possible systemic effect.