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Retinal reperfusion in diabetic retinopathy following treatment with anti-VEGF intravitreal injections

Authors Levin AM, Rusu I, Orlin A, Gupta MP, Coombs P, D'Amico DJ, Kiss S

Received 3 August 2016

Accepted for publication 10 September 2016

Published 21 January 2017 Volume 2017:11 Pages 193—200

DOI https://doi.org/10.2147/OPTH.S118807

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Ariana M Levin, Irene Rusu, Anton Orlin, Mrinali P Gupta, Peter Coombs, Donald J D’Amico, Szilárd Kiss

Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA

Purpose: The aim of this study is to report peripheral reperfusion of ischemic areas of the retina on ultra-widefield fluorescein angiography (UWFA) following anti-vascular endothelial growth factor (VEGF) intravitreal injections in patients treated for diabetic retinopathy.
Methods: This study is a retrospective review of 16 eyes of 15 patients with diabetic retinopathy, who received anti-VEGF intravitreal injections and underwent pre- and postinjection UWFA. The main outcome measured was the presence of reperfusion in postinjection UWFA images in areas of the retina that demonstrated nonperfusion in preinjection images. Images were analyzed for reperfusion qualitatively and quantitatively by two graders.
Results: Twelve of 16 eyes (75%) or 11 of 15 patients (73.3%) demonstrated reperfusion following anti-VEGF injection. On UWFA, reperfusion was detected both within the field of 7-standard field (7SF) fluorescein angiography and in the periphery outside the 7SF. Four of 16 eyes or 4 of 15 patients did not demonstrate reperfusion, one of which had extensive scarring from prior panretinal photocoagulation.
Conclusion: In patients with diabetic retinopathy, treatment with anti-VEGF agents can be associated with reperfusion of areas of nonperfusion, as demonstrated by UWFA.

Keywords: anti-VEGF, diabetes, diabetic retinopathy, ischemia, perfusion, reperfusion

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