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Daniel B Roth, Howard F Fine, jonathan prenner, Sumit P Shah, Henry Feng; Assessing Intraocular Inflammation After Ranibizumab and Aflibercept Injections for Neovascular AMD. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1520.
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© ARVO (1962-2015); The Authors (2016-present)
Intraocular inflammation has been reported after intravitreal injections of VEGF inhibitors. We sought to determine the incidence of cellular reactions, subjective flare assessment and objective flare meter measurements after injections of ranibizumab and aflibercept.
Prospective clinical trial evaluating anterior chamber cell, anterior chamber flare and flare meter measurements assessed just before and 2-3 days after intravitreal injection of either ranibizumab or aflibercept. Both treatment naïve and eyes having received multiple prior injections were included.
106 eyes were evaluated thus far and an interim analysis was performed. Mean age was 83 years. The study eye received a mean of 18 intravitreal injections at the time of the analysis. No significant clinical inflammatory reactions were noted in any of the eyes in this study before or 2-3 days after intravitreal injection. Mean baseline flare meter measurements were 8.76 (SD=4.53) for ranibizumab and 12.04 (SD=13.69) for aflibercept (p=0.076). Post-injection, mean flare meter measurements were 10.62 (SD=5.72) for ranibizumab and 13.68 (SD=16.05) for aflibercept (p=0.162). No significant correlation was noted between drug injected and mean change in flare measurement after injection, +1.86 for ranibizumab vs +1.64 for aflibercept (p=0.936). Age, number of prior injections, and pre-injection visual acuity were not significantly associated with differences in absolute flare meter measurements or with changes in flare meter measurements after injection.
No significant short-term intraocular inflammation was noted in this cohort of eyes receiving repeated intravitreal injections of ranibizimab or aflibercept for the treatment of neovascular AMD. The increase in flare measurements after injection are of unclear significance. Recruitment of additional patients in this study and sub-group analysis will further elucidate this matter.
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