Impact of Intravitreal Ranibizumab on Vessel Functionality in Patients With Retinal Vein Occlusion

Am J Ophthalmol. 2015 Jul;160(1):45-52.e1. doi: 10.1016/j.ajo.2015.04.019. Epub 2015 Apr 18.

Abstract

Purpose: To investigate the short-term effects of intravitreal ranibizumab on retinal vessel functionality in patients with retinal vein occlusion (RVO).

Design: Prospective, interventional case series.

Methods: We enrolled 11 eyes of 11 consecutive treatment-naïve patients with macular edema secondary to RVO. All patients underwent a complete ophthalmic evaluation, including optical coherence tomography and dynamic and static retinal vessel analysis, using the Dynamic Vessel Analyzer (Imedos, Jena, Germany) before (baseline) and 1 week and 1 month after administration of intravitreal ranibizumab. Investigations of RVO patients were compared to 11 eyes of age- and sex-matched control subjects.

Results: In RVO patients, dynamic analysis showed a significant increase of mean venous dilation from +2.46% ± 1.03% at baseline to +3.96% ± 1.3% at 1 week (P = .001). At 1 week mean maximum venous and arterial dilations did not differ from those of control subjects. Static analysis showed a mean overall significant decrease of central retinal artery equivalent and central retinal vein equivalent from baseline to 1 week (from 174.8 ± 22.5 measurement units [MU] to 167.2 ± 26.7 MU [P = .04], and from 228.4 ± 20.7 MU to 217.3 ± 22.8 [P = .0002]). Mean central retinal artery equivalent in healthy control subjects was 175.9 ± 10.45 MU, not significantly different from baseline, week 1, and month 1 of RVO eyes. Conversely, mean central retinal vein equivalent was 195.5 ± 9.91 MU in healthy control subjects, significantly different from baseline, week 1, and month 1 of RVO eyes.

Conclusions: Using the Dynamic Vessel Analyzer in patients with RVO, we found that intravitreal ranibizumab increased vein dilation (dynamic analysis) and had a vasoconstrictive effect on both arteries and veins (static analysis).

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Blood Pressure / physiology
  • Female
  • Heart Rate / physiology
  • Humans
  • Intravitreal Injections
  • Macular Edema / drug therapy*
  • Macular Edema / etiology
  • Macular Edema / physiopathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Ranibizumab
  • Retinal Vein Occlusion / complications
  • Retinal Vein Occlusion / drug therapy*
  • Retinal Vein Occlusion / physiopathology
  • Retinal Vessels / physiopathology*
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Ranibizumab