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Short-term effect of intravitreal ranibizumab on intraocular concentrations of vascular endothelial growth factor-A and pigment epithelium-derived factor in neovascular glaucoma.

AbstractBACKGROUND:
This study aims to evaluate concentrations of pigment epithelium-derived factor (PEDF) and vascular endothelial growth factor (VEGF)-A in aqueous of patients with neovascular glaucoma prior to, and shortly after, an intravitreal ranibizumab injection.
DESIGN:
Interventional comparative study.
PARTICIPANTS:
The study included patients undergoing an intravitreal ranibizumab injection about one week before anti-glaucomatous surgery (study group) or who underwent routine cataract surgery (control group).
METHODS:
Aqueous and blood samples were collected at the occasions of intravitreal injections, anti-glaucomatous surgery or cataract surgery. They were analysed by enzyme-linked immunosorbent assay.
MAIN OUTCOME MEASURES:
Concentrations of PEDF and VEGF-A in aqueous.
RESULTS:
At baseline, concentrations VEGF-A (3698 ± 2105 pg/mL vs. 233 ± 98 pg/mL) and PEDF (18.9 ± 11.9 ug/mL vs. 2.2 ± 0.6 ug/mL) were higher (P < 0.001) in the study group (n = 20 patients) than control group (n = 20 patients). The VEGF-A/PEDF concentration ratio was higher in the study group (396 ± 554 vs. 110 ± 49; P = 0.02). One week after the ranibizumab injection, iris neovascularization had completely regressed in 17 (85%) eyes, and VEGF-A concentration decreased significantly (P < 0.001) to 184 ± 130 pg/mL. The PEDF concentration remained unchanged (19 ± 12 ug/mL). The VEGF-A/PEDF concentration ratio decreased to 13.2 ± 13.6. Plasma concentrations of VEGF-A and PEDF did not differ significantly between both groups (P = 0.65 and P = 0.15, respectively) nor were they significantly correlated with the aqueous concentrations (all P > 0.15).
CONCLUSIONS:
Aqueous concentrations of VEGF-A and PEDF were significantly elevated in eyes with neovascular glaucoma. Within one week after intravitreal injection of ranibizumab, VEGF-A concentration decreased to subnormal levels, while the PEDF concentration remained unchanged and the VEGF-A/PEDF ratio decreased.
AuthorsJia Wei Wang, Min Wen Zhou, Xiulan Zhang, Wen Bin Huang, Xin Bo Gao, Wei Wang, Shida Chen, Xin Yu Zhang, Xiao Yan Ding, Jost B Jonas
JournalClinical & experimental ophthalmology (Clin Exp Ophthalmol) Vol. 43 Issue 5 Pg. 415-21 (Jul 2015) ISSN: 1442-9071 [Electronic] Australia
PMID25488632 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2014 Royal Australian and New Zealand College of Ophthalmologists.
Chemical References
  • Angiogenesis Inhibitors
  • Eye Proteins
  • Nerve Growth Factors
  • Serpins
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • pigment epithelium-derived factor
  • Ranibizumab
Topics
  • Adult
  • Aged
  • Angiogenesis Inhibitors (therapeutic use)
  • Aqueous Humor (metabolism)
  • Enzyme-Linked Immunosorbent Assay
  • Eye Proteins (metabolism)
  • Female
  • Fluorescein Angiography
  • Glaucoma, Neovascular (drug therapy, metabolism)
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Nerve Growth Factors (metabolism)
  • Prospective Studies
  • Ranibizumab (therapeutic use)
  • Serpins (metabolism)
  • Vascular Endothelial Growth Factor A (antagonists & inhibitors, metabolism)
  • Visual Acuity

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