J Korean Ophthalmol Soc.  2014 Feb;55(2):216-221. 10.3341/jkos.2014.55.2.216.

The Effect of Bevacizumab on Retinal Vessel Diameter, Intraocular Pressure, Retinal Nerve Fiber Layer and the Optic Disc

• Kang JY
• Lee SU
• Nam KY
• Lee JE
• Lee SJ

• KMID: 2218414
• DOI: http://doi.org/10.3341/jkos.2014.55.2.216

Abstract

PURPOSE
To evaluate the effects of a single intravitreal bevacizumab injection on retinal vessel diameter, intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness and the optic disc in patients with diabetic macular edema (DME).
METHODS
In this retrospective study, 63 eyes with DME were included. All patients received an intravitreal injection of 1.25 mg bevacizumab. We reviewed retinal vessel diameter, IOP RNFL thickness and vertical cup-to-disc (C/D) ratios at the baseline and 7 days, 1 month, 3 months and 6 months after injection. The diameter of the central retinal arteries and veins were measured using retinal photographs. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated using the revised Parr-Hubbard formula. RNFL thickness was obtained using optical coherence tomography. The vertical C/D ratio of the optic disc was evaluated using stereoscopic optic disc photography.
RESULTS
After bevacizumab injection, the CRAE significantly decreased at 7 days and 1 month postoperatively compared to baseline (p < 0.001 and p = 0.036, respectively). However, the changes in the CRAE at 3 months and 6 months were not statistically significant (p = 0.992 and p = 0.342, respectively). There were no statistically significant changes in the CRVE, mean IOP, RNFL thickness and vertical C/D ratios of the optic disc.
CONCLUSIONS
A single intravitreal bevacizumab injection transiently decreased the diameters of central retinal arterioles, but induced no significant changes in central venular diameter, mean IOP, RNFL thickness or vertical C/D ratios of the optic disc.

Keyword

Anti-VEGF; Bevacizumab; Diabetic macular edema; Retinal vessel diameter

MeSH Terms

Arterioles
Humans
Intraocular Pressure*
Intravitreal Injections
Macular Edema
Nerve Fibers*
Photography
Retinal Artery
Retinal Vessels*
Retinaldehyde*
Retrospective Studies
Tomography, Optical Coherence
Veins
Bevacizumab
Retinaldehyde

Figure

• 

  Figure 1. Measurement of retinal vessel diameter. Zone A is 0.5 disc diameters from the optic disc margin, and Zone B is 0.5 to 1 disc diameter from the optic disc margin. Red color indicates retinal arterioles, and blue color indicates retinal venules. All retinal vessels were measured in Zone B using computer-assisted software. The central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) were calculated using the revised Parr-Hubbard formula.

• 

  Figure 2. Mean changes in central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) after intravitreal bevacizumab injection. The CRAE significantly decreased at 7 days and 1 month compared to baseline (p < 0.001, p = 0.036). However the changes in CRVE were not statistically significant (p = 0.277, p = 0.952, p = 0.171, p = 0.108).

• 

  Figure 3. Mean changes in intraocular pressure (IOP) after intravitreal bevacizumab injection. Compared to baseline, there were no statistically significant changes at any follow-up period (p = 0.308, p = 0.209, p = 0.320, p = 0.779).

• 

  Figure 4. Mean changes in retinal nerve fiber layer (RNFL) thickness after intravitreal bevacizumab injection. Compared to baseline, there were no statistically significant changes at any follow-up period (Imax: p = 0.523, p = 0.657, p = 0.069, p = 0.152, Smax: p = 0.138, p = 0.417, p = 0.549, p = 0.551, Iavg: p = 0.828, p = 0.574, p = 0.139, p = 0.416, Savg: p = 0.119, p = 0.435, p = 0.353, p = 0.736).

• 

  Figure 5. Mean changes in vertical cup-to-disc (C/D) ratios after intravitreal bevacizumab injection. Compared to baseline, there were no statistically significant changes at any follow-up period (p = 0.881, p = 495, p = 0.772, p = 0.522).

Reference

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