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Aflibercept clearance through the drainage system in a rat model
Yariv Keshet1,2, Orly Gal-Or3,4, Michal Schaap Fogler3,4
1Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel. yarivkeshet@gmail.com.
International Journal of Retina and Vitreous
|September 9, 2021
Summary
Aflibercept clears completely from the rat anterior chamber angle within 48 hours, refuting theories linking its aggregation to elevated intraocular pressure. This finding is crucial for understanding anti-VEGF treatment side effects.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pharmacokinetics
Background:
- Intravitreal anti-VEGF injections are standard for retinal diseases.
- The cause of secondary elevated intraocular pressure (IOP) post-injection remains unclear.
Purpose of the Study:
- To investigate Aflibercept clearance from the anterior chamber angle in a rat model.
- To determine if Aflibercept aggregation contributes to IOP elevation.
Main Methods:
- Choroidal neovascularization induced in rats.
- Intravitreal Aflibercept injected; rats euthanized at intervals (3-48h).
- Histological and immunofluorescence staining used to track Aflibercept.
Main Results:
- Aflibercept detected in the iridocorneal angle immediately post-injection.
- Strong signal persisted at 3-6h, concentrating in Schlemm's canal at 6h.
- Signal decreased by 24h and was absent by 48h, indicating complete clearance.
Conclusions:
- Aflibercept is completely cleared from the anterior chamber angle within 48 hours in this rat model.
- This rapid clearance refutes mechanical obstruction by Aflibercept aggregation as a cause of IOP elevation.
- Aflibercept evacuation time is comparable to Bevacizumab in the same model.
