Fukami Marie, Iwase Takeshi, Yamamoto Kentaro, Kaneko Hiroki, Yasuda Shunsuke, Terasaki Hiroko
Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Invest Ophthalmol Vis Sci. 2017 Feb 1;58(2):1246-1255. doi: 10.1167/iovs.16-21115.
To evaluate the effects of an intravitreal ranibizumab (IVR) injection on the retinal microcirculation of eyes with macular edema secondary to a branch retinal vein occlusion (BRVO).
Twenty-six eyes of 26 patients with macular edema due to a BRVO that had received a single IVR injection (0.5 mg/0.05 mL) were studied. The retinal microcirculation was assessed by laser speckle flowgraphy (LSFG) using the mean blur rate (MBR) and relative flow volume (RFV). The size of the retinal arteries and veins surrounding the optic nerve head were measured separately. All of the examinations were made before, and at 1 week, and 1 and 2 months after the IVR.
The visual acuity improved significantly, and the mean central macular thickness decreased significantly during the follow-up period (both P < 0.001). The mean MBRall and MBRtissue decreased significantly at 1 week and 1 month after the IVR (both P < 0.001). The total RFV of the arteries and veins decreased significantly at 1 week and 1 month after the IVR injection in the occluded and nonoccluded quadrants (all P < 0.001). The width of the arteries and veins in the LSFG images decreased significantly at 1 week and 1 month after the IVR injection (P < 0.001).
An IVR injection leads to a transient vasoconstriction of the retinal arteries and veins and a reduction of the retinal blood flow and velocity in both the occluded and nonoccluded quadrants. The changes in retinal microcirculation might be related to the improvement of the macular edema and vision.
评估玻璃体内注射雷珠单抗(IVR)对视网膜分支静脉阻塞(BRVO)继发黄斑水肿患者视网膜微循环的影响。
对26例因BRVO继发黄斑水肿且接受单次IVR注射(0.5mg/0.05mL)的患者的26只眼进行研究。采用激光散斑血流图(LSFG)通过平均模糊率(MBR)和相对血流量(RFV)评估视网膜微循环。分别测量视神经乳头周围视网膜动脉和静脉的大小。所有检查均在IVR注射前、注射后1周、1个月和2个月进行。
随访期间视力显著提高,平均中心黄斑厚度显著降低(均P<0.001)。IVR注射后1周和1个月时,平均全视网膜MBR和组织MBR均显著降低(均P<0.001)。IVR注射后1周和1个月时,阻塞象限和非阻塞象限的动静脉总RFV均显著降低(均P<0.001)。IVR注射后1周和1个月时,LSFG图像中的动静脉宽度显著降低(P<0.001)。
IVR注射导致视网膜动静脉短暂血管收缩,阻塞象限和非阻塞象限的视网膜血流和速度均降低。视网膜微循环的变化可能与黄斑水肿和视力的改善有关。