Abstract
Purpose: To assess ocular hemodynamic response to intravitreal pegaptanib in patients with age related macular degeneration (AMD).Methods: Both eyes of twenty patients with choroidal neovascular membrane of at least four MPS (Macular Photocoagulation Study) disc area in one eye due to AMD were undergoing ocular hemodynamic evaluation. Blood flow velocities of both eyes were measured by Color Doppler Ultrasonography (CDU) before and at first, fourth weeks after intravitreal pegaptanib injection and calculated the arterial resistivity indices. The Wilcoxon-signed rank test was used for statistical analysis. Results: In the treated eyes, the mean PSV (Peak Systolic Velocity) of OA (Ophthalmic Artery) increased significantly to a value of 45.37 ± 17.92 at the first (p=0.007), then returned to an insignifi cant value of 42.19 ± 14.35 at the fourth week (p>0.05). The mean PSV of CRA (Central Retinal Artery) increased signifi cantly to a value of 21.59 ± 6.21 at the first week (p=0.12) and, then remained in a significant value of 21.06 ± 4.95 at the fourth week (p=0.006). The mean EDV (End-Diastolic Velocity) of CRA increased significantly to a value of 6.07 ± 2.30 at the first week (p=0.001) and, then remained in a significant value of 6.20 ± 2.24 at the fourth week (p= 0.001). The mean PSV of PCA (Posterior Ciliary Artery) increased significantly to a value of 30.66 ± 10.73 at the first week in comparison to the value of at the fourth week (p=0.038). However, there was no significantly difference with value of 26.57 ± 5.91 at the fourth week (p>0.05), when compared with pretreatment measurement (27.60 ± 7.84). CDU measurements in untreated eyes did not show any significant change following and before the injection. Conclusion: Resistivity indices of CRA, PCA and OA were not altered following intravitreal pegaptanib as an anti- VEGF agent in patients with AMD.
Highlights
Age-related macular degeneration is a major cause of irreversible visual loss in developed countries in 65 years and older
Neovascular age related macular degeneration (AMD) is characterized by choroidal neovascular membrane (CNVM) that due to the formation of abnormal blood vessels, which grow from the choroid into or under the retina [1]
The Vascular endothelial growth factor (VEGF) that released by retina pigment epithelium (RPE) cells in response to hypoxic stress is the most important of the angiogenic factors to stimulate the growth of new vessels [3]
Summary
Age-related macular degeneration is a major cause of irreversible visual loss in developed countries in 65 years and older. Neovascular AMD is characterized by choroidal neovascular membrane (CNVM) that due to the formation of abnormal blood vessels, which grow from the choroid into or under the retina [1]. CNVM, is present in only 10% of patients with AMD. It is responsible for 90% of cases with severe vision loss from hemorrhage and fibrosis. The Vascular endothelial growth factor (VEGF) that released by RPE cells in response to hypoxic stress is the most important of the angiogenic factors to stimulate the growth of new vessels [3]. The formation of CNVM in AMD has been shown to be related to increase levels of VEGF. Anti-VEGF agents have drammatically improved the prognosis of patients with neovascular AMD [4,5]
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