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Joachim Eckart Nasemann; Aflibercept improves retinal blood flow in eyes with central retinal vein occlusion (CRVO).. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4601.
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© ARVO (1962-2015); The Authors (2016-present)
Visual acuity and retinal blood flow are severely impaired in central retinal vein occlusion (CRVO). It is known from several studies that intravitreal injection of aflibercept improves vision in most patients by reducing macular edema which is typically found in eyes with CRVO. Little is known about change of retinal blood flow in eyes treated with injections of aflibercept. Angiographic perfusion time measurements were therefore performed in patients with CRVO prior and after aflibercept injections to quantify the therapeutic effect of aflibercept on retinal circulation.
Systemic and ocular circulation times of an intravenously injected small fluoresceine bolus were measured by recording dynamic angiograms using a Heidelberg Retina Angiograph (HRA) with a time resolution of 8.8 images per second and a field of 55 degrees. Injection-Retina-Time (IRT) and retinal perfusion time (RPT) were calculated with a newly developed algorithm reflecting total retinal perfusion. The CRVO-eye and the contralateral eye of seven patients were investigated within three days before injection and two weeks after first injection of aflibercept. In addition OCTs of macula and optic disc were performed. The contralateral eye served as control.
In control eyes mean retinal perfusion time (RPT) was 9.3 seconds (n=7). In CRVO-eyes mean RPT was delayed to 23.9 seconds (n=7). The delay of RPT in CRVO eyes therefore was 156 % of the RPT in control eyes.After aflibercept injection retinal perfusion time improved in all treated eyes (p<0.01). Mean RPT after first aflibercept injection was 17.5 seconds. The relative improvement therefore was 44 % of the delay before aflibercept injection.A reduction of macular edema as well of disc swelling was recorded in all aflibercept treated eyes. Also the diameter of the engorged retinal veins was reduced after aflibercept injection.
Retinal blood flow was severely reduced in all CRVO-eyes compared with the contralateral eye. After a single injection of aflibercept a clear improvement of retinal blood circulation could be demonstrated in all CRVO-eyes. This improvement was most probably due to reduced swelling of optic disc and was accompanied by a reduction of engorgement of retinal veins.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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