June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Autoregulation of retinal vessel diameter in diabetic macular edema is not altered by intravitreal ranibizumab
Author Affiliations & Notes
  • Anastasia Siegel
    Ophthalmology, TU Dresden, Dresden, Germany
  • Michael Haustein
    Ophthalmology, TU Dresden, Dresden, Germany
  • Naim Terai
    Ophthalmology, TU Dresden, Dresden, Germany
  • Lutz Pillunat
    Ophthalmology, TU Dresden, Dresden, Germany
  • Richard Stodtmeister
    Ophthalmology, TU Dresden, Dresden, Germany
  • Eberhard Spoerl
    Ophthalmology, TU Dresden, Dresden, Germany
  • Footnotes
    Commercial Relationships Anastasia Siegel, Novartis, Nuremberg (F), Novartis, Nuremberg (R); Michael Haustein, None; Naim Terai, None; Lutz Pillunat, None; Richard Stodtmeister, Novartis (F); Eberhard Spoerl, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 2372. doi:
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    • Get Citation

      Anastasia Siegel, Michael Haustein, Naim Terai, Lutz Pillunat, Richard Stodtmeister, Eberhard Spoerl; Autoregulation of retinal vessel diameter in diabetic macular edema is not altered by intravitreal ranibizumab. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2372.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

In patients with diabetic macular edema the autoregulatory response of retinal vessel diameter before and three times after intravitreal injections of ranibizumab was investigated

 
Methods
 

30 eyes of 30 patients aged 60±11years (mean ± SD) (M/F: 14/16) participated in this prospective study. Inclusion criterion: clinically significant diabetic macular edema. Treatment: three intravitreal injections of ranibizumab at intervals of four weeks. Examination time points: before first (TP1), second (TP2), third (TP3) injection and three months after the first one (TP4). Parameters: Systemic blood pressure, retinal vessel diameter by still images: central retinal artery (CRAE) and vein equivalent (CRVE) (Visualis, Imedos, Germany) and change in vessel diameter in response to flicker stimulation (Dynamic Vessel Analysis, Imedos, Germany): 50s baseline recording followed by online measurement during 20s flicker stimulation (push-pull interruption of fundus illumination) and 80s online measurement in an arteriolar and venolar vessel segment. Three recording cycles were averaged. Statistics: Analysis of variance (ANOVA) for repeated measurements or Friedman-test, Student t-test for paired samples, Bonferroni-Holm correction (SPSS 17). Target figures: Diameter change of retinal arterioles and venoles. Level of significance: alpha=5%.

 
Results
 

Systolic blood pressure BP: 160±18(mmHg,arith.mean±s), diastolic BP: 86±11. No significant change TP1-TP4 (p=0.10). CRAE in µm: TP1: 182±23, TP2: 172±22, TP3: 174±27, TP4: 171±22 (ANOVA: p=0.02). CRVE TP1: 216±25, TP2: 213±25, TP3: 215±24, TP4: 211±24 (ANOVA: p=0.12). Flicker response, dilation,%: Arterioles TP1: -4.80,1.20,5.7; venoles TP1: -0.90,2.65,7.2. No significant change TP1-TP4 (Friedman-test): arterioles: p=0.13, venoles: p=0.15. The differences of the flicker response TP2-TP1, TP3-TP1, TP4-TP1 didn’t differ significantly from zero (p>0.10).

 
Conclusions
 

The CRAE may be significantly lower from TP2-TP4 compared to TP1 before the first injection of ranibizumab. This observation is consistent with earlier findings in the literature. The CRVE, however, doesn’t show a significant change. The median flicker response in arterioles and venoles is remarkably lower compared to healthy subjects and shows no significant change after ranibizumab treatment.

 
 
Dilation of venoles in percent
 
Dilation of venoles in percent
 
 
Dilation of arterioles in percent
 
Dilation of arterioles in percent
 
Keywords: 499 diabetic retinopathy • 505 edema  
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