Short-term effects of intravitreal bevacizumab (Avastin<sup>®</sup>) on retrobulbar hemodynamics in patients with neovascular age-related macular degeneration

Toklu, Yasin; Çakmak, Hasan Basri; Raza, Sabri; Anayol, Alpaslan; Asik, Elif; Şimşek, Şaban

doi:10.1111/j.1755-3768.2010.02075.x

Cited by 22 publications

(20 citation statements)

References 20 publications

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“…The results of the study revealed that PSV-OA, MV-OA and PSV-MCA showed significant decreases after IVB treatment. Our findings were compatible with previous reports which demonstrated decreased OBF velocities after IVB treatment in miscellaneous ophthalmic diseases [13,14,19]. …”

Section: Discussionsupporting

confidence: 83%

“…Besides, it has been shown that decreased blood flow velocities accompany the increased RI [13]. Studies have proposed that a decrease in blood flow velocities with increased RI is related to the thromboembolic side effect of bevacizumab in the arterial system [27].…”

Section: Discussionmentioning

confidence: 99%

“…Studies investigated the effect of IVB treatment on retrobulbar hemodynamics in different ophthalmic disorders and demonstrated that IVB causes prominent changes in ocular perfusion [13,14]. Furthermore, several authors have reported on OBF analysis among premature infants with or without ROP [15,16,17].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Single Intravitreal Bevacizumab on Ophthalmic and Middle Cerebral Arterial Blood Flow in Retinopathy of Prematurity

et al. 2016

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Purpose: To evaluate the effect of a single intravitreal bevacizumab (IVB) injection on blood flow parameters in the ophthalmic artery (OA) and middle cerebral artery (MCA) in infants with retinopathy of prematurity (ROP). Materials and Methods: This prospective and interventional study included 15 infants with ROP who were treated with IVB. Peak systolic velocity (PSV), end-diastolic velocity, mean velocity (MV) and resistivity index were measured using pulse wave Doppler ultrasonography (Philips En Visor C, Amsterdam, The Netherlands) in the OA and MCA, before IVB injection and 1 day, 1 week and 1 month after IVB injection. Results: Measurements of PSV-OA, MV-OA and PSV-MCA showed significant changes after IVB treatment (p = 0.01, p = 0.02, p = 0.02, respectively). The PSV-OA measurements at 1 week and 1 month were significantly lower than the baseline PSV-OA measurement (p = 0.03 and p = 0.01, respectively). The MV-OA measurement was significantly lower at 1 month following IVB as compared to the baseline MV-OA measurement (p = 0.03). The PSV-MCA showed a significant decline 1 day after IVB injection (p = 0.03). Conclusions: The study demonstrated that IVB causes significant alterations in blood flow parameters in the OA and MCA predicted by Doppler ultrasonography in infants with ROP.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Effect of Single Intravitreal Bevacizumab on Ophthalmic and Middle Cerebral Arterial Blood Flow in Retinopathy of Prematurity

et al. 2016

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“…The finding of a major increase of RBFV occurring in arterioles supports the theory of vasoconstriction being the major driver of increase in RBFV. 20,21 In this set of patients, we found only a weak association between changes in IOP and blood flow velocity (data not shown). We therefore conclude that changes in RBFV were not substantially affected by changes in IOP.…”

Section: Main Findingsmentioning

confidence: 90%

Blood flow velocity measured using the Retinal Function Imager predicts successful ranibizumab treatment in neovascular age-related macular degeneration: early prospective cohort study

Böhni

Howell

Bittner

et al. 2015

Eye

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Purpose Anti-VEGF treatment has a potent vasoconstrictive effect. Early changes of retinal blood flow velocity (RBFV) measured using the Retinal Function Imager (RFI) combined with indicators of vascular status may help in predicting the visual outcome 1 month post injection in patients with neovascular age-related macular degeneration (nvAMD) under ranibizumab treatment. To develop a simple prediction model based on the change in RBFV 3 days post injection and indicators of a patient's vascular status to assess the probability of a successful visual outcome 1 month post injection.Methods RBFV measured using RFI were prospectively collected pre-injection and 3 days post injection in 18 eyes of 15 patients. Indicators of vascular status (history of hypertension, diabetes mellitus without retinal affection, and smoking) were assessed by medical history. By univariate analyses, parameters associated with visual outcome were weighted (−1 to 6 points). A multivariate logistic regression model with the categorized visual outcome parameter (≥0 letters gained after 1 month) as the dependent variate and the sum score as the independent variate (continuous scale) was used to estimate the score value-specific probabilities of letters gained ≥ 0 1 month post injection. Results The indicators of vascular status negatively influenced the likelihood of a letter gain ≥ 0 whereas an increase in the arterial RBFV strongly increased it. The area under the receiver operating characteristics curve for these parameters investigated was 0.71 (95% CI: 0.43-1.00). Conclusion Changes in the arterial RBFV following 3 days after ranibizumab injection combined with three indicators of the vascular status identified nvAMD patients with favorable visual outcome accurately.

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“…[54][55][56][57][58] After treatment with intravitreal anti-VEGF (bevacizumab), an initial decrease of the blood flow velocity in the central retinal 56 and short posterior ciliary arteries 56,57 had been detected in the early post-operative period, but returned to pre-operative values after one month. 56 On the other hand, combination therapy of exudative ARMD with intravitreal triamcinolone and photodynamic therapy had no significant effect on the retrobulbar blood flow parameters. 58 Photodynamic therapy alone had a temporary effect on the circulatory parameters in the short posterior ciliary artery that returned to the pre-treatment values four weeks later.…”

Section: -53mentioning

confidence: 99%

Colour Doppler Imaging of Ocular and Orbital Blood Vessels in Retinal Diseases

Dimitrova¹

2011

European Ophthalmic Review

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ImagingColour Doppler Imaging (CDI) is an established method for investigation of the ocular and orbital blood flow characteristics. It is an ultrasonographic method that has been employed for the evaluation of the circulatory status in much ocular pathology, but is most used for the investigation of the circulatory status in retinal vascular disorders and in glaucoma. [1][2][3] Ultrasound imaging (sonography) is accomplished with a pulse-echo technique. Pulses of ultrasound (generated by a transducer) are sent into the patient where they produce echoes at organ boundaries and within tissues. These echoes then return to the transducer, they are being detected and then displayed. Colour-flow imaging extends the use of the pulse-echo imaging principle. Echoes returning from stationary tissues are detected and presented in greyscale in appropriate locations along the scan line. The depth is determined by the echo's arrival time and the brightness is determined by the echo's amplitude. If a returning echo has a different frequency than what is emitted a frequency change has occurred because the echo-generating object was moving. If the motion is towards or away from the transducer, the Doppler shift is positive or negative, respectively. Along with the transducer, the colour-flow instrument consists of a pulser, a beam-former, a receiver, a memory and a display (see Figure 1).In ophthalmology, CDI is most often used to study the circulatory parameters in the retrobulbar blood vessels -the central retinal artery, central retinal vein, ophthalmic artery and the short and long posterior ciliary arteries. However, intraocular blood vessels have also been studied, such as vortex veins, blood vessels in the intraocular tumours, in detached retina, etc. The measurement is usually obtained through closed eyelids in a supine or in a seated position. Nagahara et al.patented a device for CDI measurement in seated subjects that increased the reproducibility of the measurement by 50% (see Figure 2). 4 The reflected ultrasound from the moving cells in the measured blood vessels is recorded by the CDI device and represented as a velocity wave. Two such velocity waves from the central retinal artery and the central retinal vein are presented in Figure 3.Several blood flow parameters can be obtained from the velocity wave, such as peak systolic blood velocity (PSV), end-diastolic blood velocity (EDV), mean blood velocity (MV), resistivity index (RI) and pulsatility index (PI): RI is calculated as (PSV-EDV)/PSV; PI is calculated as (PSV-EDV)/MV.Although the CDI device is equipped for measurement of blood vessel diameter, the dimension of the retrobulbar blood vessels is too small to obtain a reliable estimation of their diameter. Therefore, total blood flow cannot be evaluated in the retrobulbar blood vessels using CDI.The recording of the blood flow parameters of the central retinal artery and vein is obtained inside the optic nerve, a few millimetres away from the lamina cribrosa (see Figure 3). A specific finding of the blood flo...

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Short-term effects of intravitreal bevacizumab (Avastin^®) on retrobulbar hemodynamics in patients with neovascular age-related macular degeneration

Cited by 22 publications

References 20 publications

Effect of Single Intravitreal Bevacizumab on Ophthalmic and Middle Cerebral Arterial Blood Flow in Retinopathy of Prematurity

Effect of Single Intravitreal Bevacizumab on Ophthalmic and Middle Cerebral Arterial Blood Flow in Retinopathy of Prematurity

Blood flow velocity measured using the Retinal Function Imager predicts successful ranibizumab treatment in neovascular age-related macular degeneration: early prospective cohort study

Colour Doppler Imaging of Ocular and Orbital Blood Vessels in Retinal Diseases

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Short-term effects of intravitreal bevacizumab (Avastin®) on retrobulbar hemodynamics in patients with neovascular age-related macular degeneration

Cited by 22 publications

References 20 publications

Effect of Single Intravitreal Bevacizumab on Ophthalmic and Middle Cerebral Arterial Blood Flow in Retinopathy of Prematurity

Effect of Single Intravitreal Bevacizumab on Ophthalmic and Middle Cerebral Arterial Blood Flow in Retinopathy of Prematurity

Blood flow velocity measured using the Retinal Function Imager predicts successful ranibizumab treatment in neovascular age-related macular degeneration: early prospective cohort study

Colour Doppler Imaging of Ocular and Orbital Blood Vessels in Retinal Diseases

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Resources

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Short-term effects of intravitreal bevacizumab (Avastin^®) on retrobulbar hemodynamics in patients with neovascular age-related macular degeneration