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Rachel Annam, Ahmadreza Moradi, Mostafa Hanout, Mohammad Sadiq, Hongting Liu, Owhofasa Agbedia, Hyun Soo Jang, Zubir Rentiya, Yasir Sepah, Quan Dong Nguyen; Comparison of the Changes in Retinal Vessel Caliber in Patients with Age Related Macular Degeneration (AMD) before and after Treatment with Intravitreal Aflibercept. Invest. Ophthalmol. Vis. Sci. 2013;54(15):26.
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It has been reported that changes in venous caliber may be correlated with visual outcome in patients treated with ranibizumab (RBZ) for neovascular AMD. We analyzed the changes in retinal vessel caliber in neovascular AMD patients treated with aflibercept (AFL) using Interactive Vessel ANalysis (IVAN) software and correlated these changes with best corrected visual acuity (BCVA) and retinal thickness changes on optical coherence tomography (OCT).
Neovascular AMD patients treated with AFL at baseline and then monthly or PRN thereafter were included. Retinal vessel caliber was measured on color fundus photographs using the IVAN software at baseline and after treatment (mean 3 months). This semi-automated software measures central retinal artery equivalent (CRAE) and central retinal venular equivalent (CRVE) values by averaging the 6 largest arteries and 6 largest veins between 0.5 and 1 disc diameter from the disc margin. Results were then correlated to the BCVA and OCT changes obtained at the corresponding visits.
A total of nine eyes were included. Four eyes gained >5 letters and five eyes gained ≤5 letters. All eyes which gained >5 letters showed arterial vasoconstriction (median 5.8µm; range 0.4µm-9.4µm), while all eyes which gained ≤5 letters showed arterial vasodilation (median 11.1µm; range 1.1µm-15.9µm). There was a significant difference in arterial caliber change between the two groups (p=0.003). All eyes who gained ≤5 letters showed venous vasodilation, while only half of those who gained >5 letters showed venous vasodilation. The change in venous caliber was not significantly different between the two groups (p=0.66). There was no significant difference between the change in vessel caliber and difference in OCT thickness across study visits.
In eyes with neovascular AMD treated with AFL, better visual outcome may be associated with arterial vasoconstriction. Further studies with larger sample size are needed to validate the observed results.
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