Abstract
Purpose :
To investigate the short-term effects of intravitreal ranibizumab on retinal vessel functionality in patients with diabetic macular edema (DME) by Dynamic Vessel Analyzer (DVA, Imedos, Jena, Germany).
Methods :
Patients presenting with DME between April 2015 and October 2015 were enrolled in the study. All patients underwent a complete ophthalmic evaluation, including optical coherence tomography and dynamic and static retinal vessel analysis, using the DVA before (baseline) and 1 week after administration of intravitreal ranibizumab. DME subject were compared with diabetic retinopathy (RD) without DME subjects, and with normal non diabetic subjects (controls) matched for age and sex.
Results :
A total of 45 eyes of 45 subjects (15 eyes for each group) were included in the analysis. In DME patients (15 eyes), dynamic analysis showed a significant decrease of mean arterial dilation from +1.9%±2 at baseline to +0.7%±1 at 1 week (p= 0.05) and a trend decrease of mean venous dilation from +3.1%±1.6 at baseline to +2.6%±2.3 at 1 week (p= 0.37). Static analysis showed no significant differences from baseline to 1 week in DME patients. Mean arterial and venous dilation of healthy control subjects were +4%±1.4 and +5%±2.8 respectively, significantly different from baseline of DME patients (p=0.01 and p=0.015 respectively), week 1 of DME patients (p=0.00 and p=0.008 respectively) and significantly different from RD patients without DME (Dilation artery of +2%±2.7 [P= 0.015], dilation vein of +3.9%±5 [P= 0.05]). Mean central retinal artery (CRAE) of RD patients without DME were 186±18 MU, significantly different from baseline (164±15, p=0.002) and week 1 (170± 8,p=0.03) of DME eyes. CRAE was 195±20 MU in healthy control subjects, significantly different from CRAE at baseline and 1 week on DME patients, but non significantly different from RD patients without DME.
Conclusions :
Using DVA in patients with DME, dynamic analysis showed a significant decrease of mean arterial dilation from baseline to 1 week in DME eyes. Retinal vascular dilation during flicker stimulation is reduced in both patients with and without DME compared to control subjects. A significant reduction of arterial vessels could be demonstrated in DME patients compared to RD patients without DME and controls.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.