Vascular endothelial growth factor in fellow eyes of eyes injected with intravitreal bevacizumab

BACKGROUND: To study the effect on untreated fellow eyes of eyes treated with an intravitreal injection of bevacizumab. METHODS: Bevacizumab (1.25 mg/0.05 ml) was injected into the vitreous cavity of one eye (the first eye) as a preoperative adjunctive therapy for proliferative diabetic retinopathy; vitrectomy was performed 1 week later. Immediately after vitrectomy, bevacizumab (1.25 mg/0.05 ml) was injected into the fellow eye (the second eye) followed by vitrectomy 1 week later. Aqueous humor samples were obtained from both eyes in five cases just before intravitreal injection of bevacizumab and just before vitrectomy 1 week later. Vascular endothelial growth factor (VEGF) concentrations in the aqueous humor were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: VEGF concentrations in the aqueous humor of the first eyes ranged from 146 to 398 pg/ml (mean, 302+/-100 pg/ml) before intravitreal injection of bevacizumab; 1 week later, the VEGF concentrations in the injected eyes were less than 31 pg/ml, the lower limit of the ELISA, in all cases (p<0.001). The concentrations in the uninjected fellow eyes ranged from 181 to 551 pg/ml (mean, 382+/-119 pg/ml). CONCLUSIONS: There seemed to be no or a minimal effect of the intravitreal injections of bevacizumab on the uninjected fellow eyes.     

25G玻璃体切割术联合不同抗VEGF药物治疗PDR的疗效比较

目的:探讨25G玻璃体切割术联合不同抗血管内皮生长因子(VEGF)药物治疗增殖性糖尿病视网膜病变(PDR)患者的效果观察。方法:选择2018-07/2020-07本院收治的PDR患者作为研究对象,所有患者均行25G玻璃体切割术,术前7d给予抗VEGF药物,根据治疗方法分为雷珠单抗组(31例31眼)、康柏西普组(30例30眼)、阿柏西普组(29例29眼)。于玻璃体腔注射抗VEGF药物前及行玻璃体切割术时采集房水检测VEGF、色素上皮衍生因子(PEDF)水平,于术前及术后3、6mo时测定最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)。结果:各组患者玻璃体腔注药后房水VEGF水平显著降低(P<0.05),PEDF水平升高(P<0.05),三组组间比较均无差异(P>0.05)。三组手术时间、术中出血、医源性裂孔发生情况比较均无差异(P>0.05)。三组患者术后3、6mo时BCVA显著优于术前(P<0.05),CMT显著低于术前(P<0.05),三组组间比较均无差异(P>0.05)。结论:PDR患者玻璃体切割术前玻璃体腔注射抗VEGF药物可降低...     

玻璃体腔注射Bevacizumab对PDR患者增殖膜中CTGF及PEDF的影响

目的:研究增殖性糖尿病视网膜病变(PDR)玻璃体腔注射抗-VEGF药物bevacizumab后对增殖膜中结缔组织生长因子(CTGF)及色素上皮衍生因子(PEDF)的影响.方法:回顾2015-01/2016-12入本院行增殖性糖尿病视网膜病变治疗的患者117例126眼,采用病例对照的研究方法,将所选病例随机分为两组,分别为A组60例63眼和B组57例63眼.其中A组单纯进行玻璃体切割手术,B组患者在玻璃体切割术前玻璃体腔注射0.05mL/1.25mg bevacizumab.在手术中剥离取用两组患者的视网膜增殖膜进行染色,然后进行组织病理学观察,观察两组患者视网膜增殖膜中原始细胞和新生血管的变化,以及患者增殖膜中CTGF和PEDF因子的表达.结果:在对两组患者CTGF、PEDF因子表达进行观察发现,两组患者视网膜增殖膜中的CTGF和PEDF都在细胞质内表达.其中A组呈现出38眼阳性表达,阳性表达率为60.3%,相比于A组而言,B组的CTGF的阳性表达率92.1%明显更高,两组差异有统计学意义(P<0.05).而两组的PEDF阳性表达率分别为90.5%和95.2%,差异无统计学意义(P>0.05).结论:PDR患者在玻璃体腔注射抗VEGF药物bevacizumab后,视网膜的新生血管明显减少,有利于玻璃体切割手术的进行.且PDR患者玻璃体腔注射bevacizumab后,CTGF的阳性表达率明显增高,而PEDF因子在前膜上的表达则没有明显的变化.     

抗VEGF辅助PPV治疗增生性糖尿病视网膜病变的效果及作用机制分析

目的:探讨抗血管内皮生长因子(vascular endothelial growth factor,VEGF)辅助玻璃体切割术(pars plana vitrectomy,PPV)治疗增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的效果及作用机制.方法:将92例92眼行PPV的PDR患者,根据术前有无玻璃体腔注射雷珠单抗(intravitreal ranibizumab,IVR)分为单纯PPV组(41例41眼)和联合治疗组(51例51眼),其中联合治疗组于PPV术前5~7 d进行IVR.比较两组手术时间、电凝次数、硅油填充率、术后并发症发生率、术后3 mo患眼BCVA及手术前后不同时间点房水和玻璃体VEGF、色素上皮衍生因子(pigment epithelium-derived factor,PEDF)含量.结果:联合治疗组手术时间短于单纯PPV组,电凝次数少于PPV组,硅油填充、医源性视网膜裂孔及玻璃体再积血的几率均低于单纯PPV组,差异均有统计学意义(P<0.05);联合治疗组PPV时房水及玻璃体VEGF、PEDF含量低于单纯PPV组,差异均有统计学意义(P<0.05);联合治疗组术后3 mo患眼BCVA好于单纯PPV组,差异有统计学意义(P<0.05).结论:IVR联合PPV治疗PDR可降低PPV围手术期VEGF、PEDF水平,减少术中电凝次数,降低术后医源性视网膜裂孔及玻璃体再积血发生率,提高视力水平.     

Effect of vitrectomy on aqueous VEGF concentration and pharmacokinetics of bevacizumab in macaque monkeys

Purpose. To evaluate the effect of vitrectomy on the concentration of vascular endothelial growth factor (VEGF) and the pharmacokinetics of intravitreally injected bevacizumab in the aqueous humor in cynomolgus macaques. Methods. Pars plana lensectomy and a standard three-port vitrectomy were performed in one eye each of six macaques. After a minimal 12-week healing period, the vitrectomized eyes received an intravitreal injection of bevacizumab (1.25 mg/50 μL). Aqueous humor and venous blood samples were obtained from the macaques just before vitrectomy, just before injection of bevacizumab, on days 1, 3, and 7, and during weeks 2, 4, 6, and 8 after the injection. The bevacizumab and VEGF concentrations were measured by using enzyme-linked immunosorbent assay. Results. The VEGF concentrations in the aqueous humor ranged from 52.6 to 113.9 pg/mL (mean ± standard deviation [SD], 81.7 ± 27.0 pg/mL) before vitrectomy and 20.7 to 72.7 pg/mL (mean ± SD, 51.4 ± 20.5 pg/mL) 3 months after vitrectomy, a difference that reached significance (P = 0.03). The aqueous VEGF concentrations decreased to less than 9.0 pg/mL, the lower limit of detection, in all eyes between 1 and 7 days after injection of bevacizumab. The mean half-life of 1.25 mg intravitreally injected bevacizumab was 1.5 ± 0.6 days (range, 1.0-2.4 days) in the aqueous humor. Conclusions. The VEGF concentration in the aqueous humor decreased and the half-life of the intravitreally injected bevacizumab was shorter in vitrectomized eyes.     

Concentration of Vascular Endothelial Growth Factor After Intracameral Bevacizumab Injection in Eyes With Neovascular Glaucoma

Purpose

To study the concentration of vascular endothelial growth factor (VEGF) in the aqueous humor before and after intracameral injection of bevacizumab in eyes with neovascular glaucoma, and to detect the duration of an anti-VEGF effect of bevacizumab in the anterior chamber.

Methods

In this prospective interventional case series, 1.25 mg of bevacizumab was injected into the anterior chamber of five eyes in five neovascular glaucoma patients. Aqueous humor samples were obtained just before intracameral injection of bevacizumab and two weeks after injection. The concentrations of VEGF in the aqueous humor were measured using ELISA. To investigate corneal endothelial damage after intrecameral bevacizumab injection, specular microscopy was performed before injection and two weeks after injection. Slit lamp photo and iris fluorescent angiography was performed to determine the regression of iris neovascularization.

Results

After injection, substantial regression of neovascularization or fluorescein leakage was seen in all treated eyes. The VEGF concentrations in the aqueous humor in eyes with NVG were 1181.8±1248.3 pg/mL before intracameral injection of bevacizumab. Two weeks after injection, the VEGF concentrations decreased to 33.2±12.2 pg/mL (p=0.04, Wilcoxon signed rank test). There were no significant changes in IOP or corneal endothelial cells.

Conclusions

Intracameral bevacizumab injection can remarkably reduce iris neovascularization in neovascular glaucoma patients. VEGF levels were significantly decreased two weeks after injection and corneal toxicity was not observed during short term follow-up.     

23G微创玻璃体切割术联合雷珠单抗玻璃体腔注射治疗PDR

目的:观察23G微创玻璃体切割术联合雷珠单抗玻璃体腔注射治疗增生性糖尿病视网膜病变(PDR)的临床效果。方法:回顾性研究。采集2016-01/2020-01医院收治的PDR患者78例89眼,按术前是否给予雷珠单抗玻璃体腔注射治疗分为手术组(仅行23G微创玻璃体切割术,35例41眼)与联合组(23G微创玻璃体切割术联合术前玻璃体腔注射雷珠单抗治疗,43例48眼),比较两组手术时间、术中出血、术中电凝止血次数、眼内填充及视网膜裂孔发生情况;治疗前,术后1d,3mo最佳矫正视力(BCVA)、眼压、黄斑中心凹厚度(CMT)、视网膜新生血管荧光素渗漏面积的变化;治疗前、术后1wk均抽取房水测定血管内皮生长因子(VEGF)-A、人基质细胞衍生因子-1(SDF-1)、色素上皮衍生因子(PEDF)含量的变化;统计两组随访3mo手术并发症发生率。结果:联合组手术时间短于手术组,电凝止血次数、硅胶填充眼数少于手术组(P<0.05),术中总出血眼数少于手术组(P<0.05);术后1d,3mo联合组BCVA改善优于手术组(P<0.05),CMT、视网膜新生血管渗漏面积低于手术组(P<0.05);两组眼压比较无差异(P>0.05);术后1wk,两组VEGF-A、SDF-1、PEDF均降低(P<0.001),联合组房水内VEGF-A、SDF-1、PEDF均低于手术组(P<0.001);联合组医源性裂孔及玻璃体再积血发生率低于手术组(P<0.05),其余各并发症均无差异(P>0.05)。结论:23G微创玻璃体切割术联合雷珠单抗玻璃体腔注射治疗PDR整体价值优于单独应用23G微创玻璃体切割术,可降低手术难度,缩短手术时间,减少术中出血及器械操作,促进术后视力恢复,抑制视网膜新生血管生成,降低医源性损伤发生风险,并发症少,更安全有效。     

PDR患者玻璃体手术前后房水中VEGF水平的变化

目的：检测增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)患者玻璃体手术前后房水中血管内皮生长因子(vascular endothelial growth factor, VEGF)的浓度变化,研究VEGF在PDR发病机制中的作用。

方法：收集30例PDR患者玻璃体手术前后的房水标本,以30例无糖尿病的白内障患者作为正常对照组,用酶联免疫吸附分析(enzyme-linked immunosorbent assay, ELISA)方法检测VEGF的浓度。

结果：PDR患者与正常对照组相比,房水中VEGF浓度显著升高,有统计学差异(P<0.05)。PDR患者玻璃体视网膜手术后与手术前相比,房水中VEGF浓度显著降低,有统计学差异(P<0.05)。

结论：VEGF积极参与了PDR的发生发展,并与PDR后期新生血管形成有着密切的关系。     

雷珠单抗联合玻璃体切割术治疗PDR合并早期新生血管性青光眼

目的：探讨增殖性糖尿病视网膜病变(PDR)合并早期新生血管性青光眼患者采用雷珠单抗注射联合玻璃体切割术(PPV)治疗的临床效果。

方法：选取2014-07/2016-12我院眼科中心治疗的80例80眼PDR合并早期新生血管性青光眼患者,根据患者术前是否注射雷珠单抗分为预处理组(40例40眼,术前雷珠单抗注射联合PPV治疗)和常规组(40例40眼,仅采取PPV手术治疗),对比两组患者的视力、眼压等指标变化。

结果：预处理组患者的手术时间、新生血管出血次数、电凝使用次数均显著的低于常规组患者,差异均具有统计学意义(P<0.05); 术前两组患者的眼压、BCVA测定值比较,差异均无统计学意义(P>0.05); 术后1wk,3mo,预处理组患者的BCVA值显著优于常规组(P<0.05),术后1wk时,预处理组患者的眼压低于常规组(P<0.05); 术前两组患者的房水中VEGF比较,差异无统计学意义(P>0.05); 术后1mo,预处理组患者房水中VEGF显著低于常规组(P<0.05),术后3mo时,预处理组患者视网膜黄斑中心凹厚度值低于常规组(P<0.05)。

结论：PDR合并早期新生血管性青光眼患者采用雷珠单抗注射联合PPV治疗能显著地降低手术难度,提高术后视力,降低房水中VEGF的水平。     

Vascular endothelial growth factor plasma levels before and after treatment of neovascular age‐related macular degeneration with bevacizumab or ranibizumab

Purpose:  To evaluate the changes of vascular endothelial growth factor (VEGF) plasma levels after intravitreal injections of ranibizumab or bevacizumab in patients with exudative age‐related macular degeneration (AMD). Methods:  Forty‐three patients with exudative AMD and 19 age‐ and sex‐matched control patients without chorioretinal diseases were studied. Nineteen patients were treated with intravitreal ranibizumab 0.5 mg, 24 with intravitreal bevacizumab 1.25 mg. Blood samples were collected just before the first injection, and 28 days after three initial consecutive injections performed in 4‐weekly intervals (loading dose). Concentration of VEGF in the plasma was measured by ELISA. Results:  At baseline, the median VEGF concentrations in controls were 180.97 pg/ml, in the bevacizumab group 189.72 pg/ml and in the ranibizumab group 191.36 pg/ml. VEGF plasma concentrations in patients with wet AMD were comparable to controls (p = 0.225). Twenty‐eight days after the third injection, a significant reduction of 42% in the median VEGF plasma levels was found in bevacizumab‐treated patients (109.97 pg/ml; p = 0.0002) but not in ranibizumab‐treated patients (189.97 pg/ml; p = 0.198) where a reduction of 0.7% in the median value was found. Conclusions:  Intravitreal bevacizumab significantly reduced VEGF plasma levels until 28 days after intravitreal injection in patients with exudative AMD. Ranibizumab did not achieve a significant plasma VEGF reduction at the same time‐point. These findings alert to the potential systemic safety differences between the two drugs after intravitreal administration.     

BMP-6与新生血管性年龄相关性黄斑变性的相关性

目的：探讨新生血管性年龄相关性黄斑变性(nARMD)患者房水中骨形态发生蛋白6(BMP-6)、白细胞介素-6(IL-6)及血管内皮生长因子(VEGF)的变化及其与黄斑区视网膜厚度的相关性。

方法：收集2015-06/2017-03于我院眼科就诊的nARMD患者34例35眼作为nARMD组,选取同期于我院住院行白内障手术的年龄相关性白内障患者20例20眼作为对照组。采用光学相干断层扫描(OCT)测量两组患者黄斑区1mm范围内的平均视网膜厚度(CSMT)。通过ELISA法检测房水中BMP-6的浓度,流式微球技术(CBA)测量IL-6和VEGF的浓度。

结果：nARMD组患者房水中BMP-6水平(35.29±4.27pg/mL)明显低于对照组(62.04±2.78pg/mL),而VEGF水平(93.13±47.25pg/mL)明显高于对照组(69.21±13.40pg/mL),差异均有统计学意义(P<0.05),两组患者房水中IL-6的水平差异无统计学意义(P>0.05)。Spearman相关性分析表明,nARMD组患者房水中BMP-6含量与CSMT呈负相关(r_s=-0.409,P=0.015)。

结论：nARMD患眼房水中BMP-6浓度下降,而VEGF浓度升高,BMP-6含量与CSMT呈负相关,其可能参与nARMD的发病过程。     

NVG患者房水和血清中VEGF-A和PDGF及PEDF的临床意义

目的：检测新生血管性青光眼(NVG)患者房水和血清中血管内皮生长因子-A(VEGF-A)、血小板源性生长因子(PDGF)、色素上皮衍生因子(PEDF)的含量,并分析其意义。

方法：前瞻性临床研究。采用酶联免疫吸附法(ELISA)检测2015-12/2016-12在西京医院眼科住院的NVG患者23例及年龄相关性白内障患者23例房水及血清中VEGF-A、PDGF、PEDF的含量并定量分析。

结果：NVG患者房水中VEGF-A、PDGF的含量分别为1130.56±69.32、221.95±56.08ng/L,均显著高于年龄相关性白内障患者组(226.45±37.46、36.25±7.12ng/L)(均P<0.01); NVG患者房水中PEDF的含量为195.69±42.00ng/L,低于年龄相关性白内障患者组(497.89±12.52ng/L)(P<0.01); NVG组血清中VEGF-A、PDGF及PEDF的含量分别为226.45±37.46、29.57±6.31及13.24±1.76ng/L,均与年龄相关性白内障患者组(219±34.89、28.28±7.24、12.96±2.08ng/L)无差异(均P>0.05)。NVG患者房水中VEGF-A和PDGF含量呈正相关(r=0.502,P=0.015),而VEGF-A与PEDF含量呈负相关(r=-0.480,P=0.020)。

结论：NVG患者房水中VEGF-A、PDGF的含量显著升高,而PEDF的含量显著降低,且VEGF-A的含量与PDGF含量呈正相关、与PEDF含量呈负相关。联合使用VEGF-A、PDGF抑制剂及PEDF可能为NVG治疗提供新的思路。     

糖尿病视网膜病变围手术期的抗VEGF研究

目的：对比研究玻璃体腔注射抗VEGF(血管内皮生长因子)药物治疗增殖性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的临床疗效。

方法：选取我院2010-01/2015-01收治的PDR患者84例84眼,将患者随机分为A组、B组、C组,各为28例28眼。A组直接行玻璃体切除术; B组在玻璃体切除术前于玻璃体腔注射雷珠单抗; C组在玻璃体切除术前于玻璃体腔注射康柏西普。观察三组手术时间、并发症和术后6mo最佳矫正视力。

结果：治疗后,B组、C组术中及术后并发症的发生率以及手术时间显著低于A组。三组患者术后6mo最佳矫正视力比较,A组术前、术后视力组内比较差异均有统计学意义(P<0.05),三组在治疗后视力改善有效率方面比较,无统计学差异(P>0.05)。

结论：玻璃体切除术前注射雷珠单抗和康柏西普能有效缩短手术时间,减少术中及术后并发症,并能显著提高患者最佳矫正视力。     

增生性玻璃体视网膜疾病眼内液血管内皮生长因子的表达

目的 观察增生性玻璃体视网膜疾病患者眼内液（房水、玻璃体）中血管内皮生长因子（VEGF）含量的变化规律，探讨VEGF在增生性玻璃体视网膜疾病发展变化中的作用。 方法 采用双抗体夹心酶联免疫吸附试验(ELISA)定量检测增生性玻璃体视网膜病变（PVR）、视网膜静脉阻塞（RVO）、增生性糖尿病视网膜病变（PDR）、新生血管性青光眼（NVG）患者组及正常对照组房水、玻璃体VEGF含量。 结果 PVR、RVO、PDR、NVG患者组房水及玻璃体VEGF含量均高于正常对照组，其差异均有统计学意义(P<0.05)；NVG、PDR、RVO、PVR患者组房水及玻璃体VEGF含量依次降低 ，其差异有统计学意义(P<0.05)；PVR、RVO、PDR、NVG患者组和正常对照组玻璃体VEGF含量均高于房水VEGF含量，其差异有统计学意义(P<0.05)；PVR患者病史与房水、玻璃体VEGF含量呈负相关（r分别为－0.819、－0.823，P＜0.05）；RVO患者病史与房水、玻璃体VEGF含量呈正相关（r分别为0.913、0.929，P＜0.05）；PDR患者玻璃体积血时间与房水、玻璃体VEGF含量呈正相关（r分别为0.905、0.920，P＜0.05）。 结论 增生性玻璃体视网膜疾病患者房水及玻璃体VEGF含量明显增高，VEGF可能在增生性玻璃体视网膜疾病发展变化中起着重要的作用。 (中华眼底病杂志， 2006， 22：313-316）     

新生血管性青光眼患者眼内液血管 内皮生长因子的检测

目的了解新生血管性青光眼(neovascular glaucoma, NVG)患者房水及玻璃体中血管内皮生长因子(vascular endothelial growth factor, VEGF)的含量以及对虹膜新生血管发生的影响。方法应用酶联免疫吸附测定法(enzyme linked immu nosorbent assay, ELISA)分别对11例NVG患者行内眼手术时抽取的房水、玻璃体22个标本以及同期6例黄斑裂孔手术患者(对照组)房水、玻璃体12个标本进行VEGF检测。结果NVG患者房水、玻璃体中VEGF含量分别为(1.451±0.247)、(1.610±0.125) ng/ml,较对照组房水、玻璃体中的 VEGF含量(0.189±0.038)、(0.201±0.055) ng/ml明显增高, 两组间差别有非常显著性意义(t=12.007,P<0.001;t=26.057,P<0.001)。结论NVG患者房水、玻璃体中VEGF浓度显著增高,提示VEGF在NVG患者虹膜新生血管形成过程中可能具有一定作用。(中华眼底病杂志,2001,17:305-306)     

2型糖尿病合并白内障患者晶状体上皮细胞中PEDF和VEGF的表达及意义

目的：观察糖尿病合并年龄相关性白内障患者晶状体上皮细胞(LECs)中色素上皮衍生因子(PEDF)、血管内皮细胞生长因子(VEGF)的表达水平,探讨糖尿病合并年龄相关性白内障的发病机制。

方法：回顾性研究。收集2020-08/2021-04在蚌埠医学院第一附属医院眼科就诊的年龄相关性白内障和2型糖尿病合并年龄相关性白内障患者各30例。所有患者白内障超声乳化术中收取术眼晶状体中央区5.5～6.0mm直径的前囊膜标本,采用蛋白免疫印迹法(Western-blot)检测LECs中PEDF、VEGF蛋白表达水平。实时荧光定量PCR(qRT-PCR)方法检测PEDF、VEGF mRNA的相对表达量。

结果：两组患者LECs中均存在PEDF、VEGF的表达,2型糖尿病合并年龄相关性白内障组患者VEGF mRNA相对表达量为1.364±0.062,高于年龄相关性白内障组的1.000±0.0(P<0.01),PEDF mRNA的相对表达量为0.398±0.053,明显低于年龄相关性白内障组的1.000±0.0(P<0.001)。2型糖尿病合并年龄相关性白内障组患者LECs中VEGF和PEDF蛋白表达量为2.053±0.026、0.579±0.045,年龄相关性白内障组为1.680±0.064、1.058±0.007(均P<0.01)。

结论：2型糖尿病合并年龄相关性白内障患者LECs中PEDF和VEGF表达水平发生变化,可能与糖尿病患者白内障的发生和发展有关。     

前部视网膜冷凝术对新生血管性青光眼患者房水中血管内皮生长因子含量的影响

目的 探讨前部视网膜冷凝术对新生血管性青光眼患者房水中血管内皮生长因子（VEGF）含量的影响以及VEGF含量的变化与虹膜新生血管之间的关系。方法对28例确诊为新生血管性青光眼患者行虹膜血管造影,确定新生血管的范围和数量后,行前部视网膜冷凝术,7～14d后经虹膜血管造影确定虹膜新生血管大部分消退后,再行小梁切除术。分别于前部视网膜冷凝术前和小梁切除术前抽取房水标本,另取30例老年性白内障患者房水标本。采用酶联免疫吸附法分别测定全部房水标本中的VEGF含量。结果小梁切除术前房水中VEGF的含量[（2．096±0．512）ng／ml]明显低于前视网膜冷凝术前房水中VEGF含量[（0．478±0．312）ng／ml],两者比较差异有统计学意义（P〈0．01）。小梁切除术前房水中VEGF含量明显高于老年性白内障患者房水中VEGF的含量[（0．198±0．045）ng／ml],两者比较差异有统计学意义（P〈0．01）。结论VEGF在虹膜新生血管的形成中可能发挥一定的作用;阻断促使虹膜产生新生血管的VEGF来源,可抑制新生血管性青光眼的发生.（中华眼科杂志．2007．43：622-625）     

Alteration of intraocular pigment epithelium-derived factor and vascular endothelial growth factor in patients with diabetic retinopathy

AIM:b To determine the aqueous, vitreous, serum levels of pigment epithelium-derived factor (PEDF) and vascular endothelial growth factor (VEGF) in patients with proliferative diabetic retinopathy (PDR), and to speculate on the source of the change in concentration and to discuss its clinical significance. METHODS:b Forty-one eyes with proliferative diabetic retinopathy were included in the study, 16 of which were complicated by neovascularization of iris (NVI). Twenty-one eyes with idiopathic macular hole (MH) were as controls. The aqueous,vitreous, serum levels of PEDF and VEGF of all the groups were determined with ELISA. PEDF, VEGF and the levels in the three groups were compared with analysis of variance(ANOVA). The PEDF, VEGF concentrations in aqueous,vitreous and serum were analyzed with Pearson correlation test, and the correlation of PEDF and VEGF levels was also analyzed with Pearson correlation test. RESULTS:b The aqueous levels of PEDF decreased significantly in sequence in groups of control, PDR without NVI,PDR with NVI. VEGF levels increased coordinately. The similar findings existed in vitreous samples. The PEDF, VEGF levels in aqueous were not correlated significantly with those in serum, but correlated positively with those in vitreous. The intraocular levels of PEDF had a negative correlation to those of VEGF. CONCLUSION:b The reduction of intraocular PEDF level and elevation of intraocular VEGF level may play an important role in the occurrence and progression of PDR. In the development of PDR, the PEDF,VEGF levels in aqueous may be mainly effected by local pathological changes, as anti-angiogenic and pro-angiogenic factors, their unbalanced intraocular distribution may promote the angiogenesis of the iris and retina.     

Aqueous vascular endothelial growth factor and ranibizumab concentrations after monthly and bimonthly intravitreal injections of ranibizumab for age-related macular degeneration

Purpose

To evaluate vascular endothelial growth factor (VEGF) and ranibizumab concentrations in eyes with age-related macular degeneration (AMD) after monthly and bimonthly intravitreal ranibizumab (IVR) injections.

Methods

Aqueous humor samples were obtained from 26 eyes with AMD before and after IVR injections. Nine eyes received three monthly injections and 17 eyes received two bimonthly injections. The VEGF and ranibizumab concentrations were measured by enzyme-linked immunosorbent assay.

Results

The aqueous VEGF concentrations in the monthly injection group decreased below the lowest detectable limit in eight of nine eyes 1 month after the first injection and seven of nine eyes 1 month after the second injection (P?<?0.001, mean baseline value, 94.7 pg/ml); the aqueous VEGF concentrations in the bimonthly injection group decreased below the lowest detectable limit in two of 17 eyes 2 months after the first injection (P?<?0.001, mean baseline value, 152.4 pg/ml). The mean aqueous ranibizumab concentrations with monthly injections were 71.2 ng/ml 1 month after the first injection, and 96.3 ng/ml 1 month after the second injection. The mean aqueous ranibizumab concentrations in the bimonthly injection group were 2.5 ng/ml in 15 of 17 eyes, and below the lowest detectable limit in two of 17 eyes 2 months after the first injection.

Conclusions

In this pilot study with limited follow-up, intravitreal injection of ranibizumab can suppress aqueous VEGF completely for 1 month in most cases. Its effect does not last for 2 months enough to suppress VEGF completely in most cases, although aqueous VEGF at 2 months after intravitreal injection of ranibizumab is less than that before injection in most cases.     

Efficacy of 12‐month treatment of neovascular age‐related macular degeneration with intravitreal bevacizumab based on individually determined injection strategies after three consecutive monthly injections

Purpose: To report the results of intravitreal treatment with bevacizumab in neovascular age‐related macular degeneration (AMD) after a loading dose (LD) of three monthly injections followed by an optical coherence tomography (OCT)‐guided strategy, based on best‐corrected visual acuity (VA) and number of injections required over 1 year. Methods: A series of consecutive cases of 149 eyes of 147 patients received three or more intravitreal injections of bevacizumab (1.25 mg) for neovascular AMD over a 1‐year period. The patients underwent ophthalmological examinations: measurement of the VA, fluorescein angiography, dilated fundus examination at baseline; VA, OCT and dilated fundus examination at monthly follow‐up visits. Repeated injections were given each month for the first 3 months (LD); thereafter, injections were only administered if leakage or macular oedema were present. Results: Mean baseline VA was 51 ± 14 letters, which improved to 58 ± 15 letters (p < 0.0001; n = 149) at first evaluation (15 ± 2 weeks), 59 ± 15 letters (p < 0.0001; n = 143) at second evaluation (25 ± 2 weeks) and 57 ± 16 letters (p < 0.0001; n = 132) at third evaluation (51 ± 3 weeks). The baseline mean central retinal thickness (344.6 μm) and total macular volume (8.6 mm³) decreased at first evaluation, to 219.0 μm (p < 0.0001) and 7.2 mm³ (p < 0.0001), respectively. The mean number of injections per patient treated for 1 year was 5.1 (range 3–9). No systemic side‐effects were noted. Conclusion: Treatment of neovascular AMD with intravitreal bevacizumab administered in LD of three monthly injections and followed by an OCT‐guided strategy provides functional and anatomical improvements for up to 1 year.