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Ai Yoneda, Kiyoshi Suzuma, Yuki Maekawa, Eiko Tsuiki, Takashi Kitaoka; Comparison of retinal and choroidal blood flow changes after treatment with ranibizumab or aflibercept in exudative age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4597.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the impact of ranibizumab versus aflibercept treatment on retinal and choroidal blood flow in exudative age-related macular degeneration (AMD).
Retrospective observational case series of eyes with exudative AMD that had received 3 consecutive monthly injections of either ranibizumab or aflibercept. Retinal blood flow at the optic disc and choroidal blood flow at the macula with or without focal lesion were measured by laser speckle flowgraphy before and 1 month after each monthly injection and subsequently evaluated using the mean blur rate (MBR).
The study included 38 patients: 20 treated with ranibizumab and 18 with aflibercept. Compared to baseline (100%), the average MBR at the macula with focal lesion was significantly decreased after the 1st (82±19%, p<0.01), 2nd (84±25%, p<0.01) and 3rd (86±21%, p<0.01) injections only in the aflibercept group. It was significantly different between the aflibercept group and the ranibizumab group after 3rd injection (p<0.05). The average MBR at the macula without focal lesion was also significantly decreased after the 1st (86±15%, p<0.05), 2nd (87±20%, p<0.01) and 3rd (88±17%, p<0.01) injections in the aflibercept group. In the ranibizumab group, the average MBR at the macula without focal lesion was significantly decreased only after the 2nd (90±12%, p<0.01) injection. There was no significant difference in the average MBR in the retinal vessels at the disc area in both groups. Compared to baseline, mean visual acuity in logMAR was significantly improved in both groups at 1 month after the 3rd injection (ranibizumab: aflibercept, 0.70±0.62 to 0.44±0.55, p<0.01: 0.56±0.36 to 0.34±0.27, p<0.01). Central macular thickness (432±181µm to 289±123µm, p<0.01: 362±106µm to 261±65µm, p<0.01) and central choroidal thickness (247±69µm to 231±67µm, p<0.01: 257±68µm to 222±63µm, p<0.01) were significantly decreased in both groups.
Intravitreal injections of aflibercept significantly reduced the choroidal blood flow better than ranibizumab. The retinal blood flow was not decreased either after ranibizumab and aflibercept injections.
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