Effect of intravitreal aflibercept (Eylea®) on retrobulbar hemodynamics in patients with neovascular age-related macular degeneration

Purpose To investigate the short-term effect of single intravitreal aflibercept injection on retrobulbar blood flow in patients with neovascular age-related macular degeneration (nAMD). Methods Twenty eyes of 20 patients with nAMD scheduled for single intravitreal aflibercept (Eylea((R))) injection and 20 fellow eyes (uninjected) were enrolled in this prospective interventional study. The hemodynamic parameters of the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) comprising peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were measured by using color Doppler ultrasonography (CDU) in both injected and uninjected fellow eyes at baseline and 1 week after the injection. Results The measured first-week values of PSV and EDV in the CRA, OA and PCA showed a statistically significant reduction when comparing baseline values in both injected and uninjected fellow eyes (p = 0.0001). Also, it was found a significant increase in the post-injection RI values of all the CRA, OA, PCA in injected eye and OA in the uninjected eye (p = 0.0001). There was any significant difference between pre- and post-injection RI values of the CRA and PCA in the fellow eyes (p = 0.137, p = 0.736, respectively). Conclusion Single intravitreal administration of aflibercept alters retrobulbar blood flow velocities (BFVs) in both injected and uninjected fellow eyes in the short-term period.