Intravitreal Aflibercept and Faricimab decreases ocular blood flow to optic nerve head and peripapillary retinal vessels: Study
Diabetic retinopathy (DR) is the primary cause of visual impairment among working-age populations in industrialized nations. Vision loss may result from various mechanisms, but the most prevalent cause is diabetic macular edema (DME). The treatment landscape for DME has advanced significantly over the past decade. Currently, the most frequently employed therapeutic approach involves intravitreal administration of anti-vascular endothelial growth factor (VEGF) agents, and the prognosis of patients with DME has markedly improved. There are various commercially available anti-VEGF agents. Older options include monoclonal antibodies such as ranibizumab and bevacizumab. While ranibizumab and bevacizumab alone inhibit VEGF-A, aflibercept, a recombinant fusion protein, inhibits VEGF-A, VEGF-B, and placental growth factor (Plgf), and faricimab, a bispecific antibody, inhibits both VEGF-A and angiopoietin-2 (Ang-2).
Laser speckle flowgraphy (LSFG) facilitates two-dimensional, non-invasive measurements of perfusion at the optic nerve head (ONH), retina, and choroid by utilizing the laser speckle phenomenon and has proven instrumental in quantifying ocular blood flow in patients with DR, retinal vein occlusion, age-related macular degeneration, or central serous chorioretinopathy. In this study, authors aimed to evaluate and compare the effects of intravitreal aflibercept (IVA) versus intravitreal faricimab (IVF) on blood flow in the optic nerve head and retinal vessels of the peripapillary region using LSFG in patients with DME. This was the first study to investigate the effect of intravitreal faricimab on ocular perfusion and compare the effects of different anti-VEGF agents on ocular blood flow one month after injection.
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