Evaluation of Serum and Aqueous Humor Vascular Endothelial Growth Factor in Neovascular Glaucoma (original) (raw)
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Medical Sciences, 2017
Vascular endothelial growth factor B (VEGF-B) is one of the enigmatic members of the VEGF family. The knowledge gap about VEGF-B expression and how its levels are altered in diabetic eyes were the focus of this investigation that was addressed by comparing and correlating vitreous VEGF-B between diabetic and non-diabetic patients. VEGF-B levels were measured by enzyme-linked immunosorbent assay in vitreous samples (n = 33) from diabetic (n = 25) and non-diabetic (n = 8) patients. Results were compared between groups. Optical coherence tomography from diabetic patients was evaluated for central retinal thickness (CRT) and macular volume (MV). Mean vitreous VEGF-B concentration was higher in diabetic (18.82 ± 1.44 pg/mL) vs. non-diabetic patients (17.90 ± 0.32 pg/mL) (p = 0.006), and in proliferative diabetic retinopathy (PDR) (19.03 ± 1.52 pg/mL) vs. non-PDR (NPDR) patients (18.18 ±0.96 pg/mL) (p = 0.025). In diabetic retinopathy (DR) patients, correlation between VEGF-B and CRT (µm) was positive and moderate: r s = 0.441 (p ≤ 0.05) and the correlation between VEGF-B and MV (mm 3) was positive and robust: r s = 0.716 (p ≤ 0.01). VEGF-B levels are overexpressed in vitreous of diabetic patients, and the levels are higher in developed stages of DR. Correlation results show that CRT and MV increase with increased levels of VEGF-B. Targeting VEGF-B inhibition may have therapeutic beneficial implications.
Diabetologia, 1997
Vascular endothelial growth factor (VEGF) plays a major role in the development of neovascularization in proliferative diabetic retinopathy (PDR). The source of intravitreous VEGF is presumably ischaemic retina, but increased levels derived from serum cannot be excluded. The aim of the study is to determine the intravitreous concentrations of VEGF in diabetic patients with PDR and to investigate whether serum VEGF could contribute to the intravitreous concentration. For this purpose, we studied 20 diabetic patients (5 IDDM and 15 NIDDM) with PDR in whom a vitrectomy was performed (group A). Non-diabetic patients (n = 13) with other conditions requiring vitrectomy served as a control group (group B). In both groups, VEGF was determined in serum and undiluted vitreous samples obtained simultaneously. Furthermore, serum VEGF was determined in 69 healthy control subjects (group C) and 39 diabetic patients without microvascular complications (group D). Vitreous and serum VEGF was determined by ELISA (R & D Systems, Abingdon, UK); intra-assay CV 3.8 %, interassay CV 5.1 %. Intravitreous concentrations of VEGF were strikingly higher in group A (median 1.75 ng/ml, range 0.33–6.66) in comparison with group B (median 0.009 ng/ml, range 0.009–0.038); p < 0.0001. This difference remained significant after adjusting for intravitreous protein concentration (p < 0.05). Differences in serum VEGF among the groups included in the study were not found. We conclude that the high vitreous levels of VEGF observed in diabetic patients with PDR cannot be attributed to serum diffusion across the blood-retinal barrier. Therefore, intraocular synthesis is the main contributing factor for the high vitreous VEGF concentrations observed in PDR. [Diabetologia (1997) 40: 1107–1109]
Growth Factors, 2018
VEGF-A and VEGF-B are proangiogenic and key regulating factors for blood vessel growth. This study aims to compare VEGF-A and VEGF-B levels in the serum and vitreous of patients with neovascular pathology versus non-neovascular pathology. Our findings showed vitreous VEGF-A and VEGF-B levels increased in patients with neovascular disease, with higher levels of VEGF-A compared to VEGF-B (p .05). In the diabetic retinopathy (DR) group, higher vitreous VEGF-A or VEGF-B were found in proliferative diabetic retinopathy (PDR) than in non-PDR. The strong correlation between VEGF-A and VEGF-B demonstrates a simultaneous pathological increase of cytokines (p < .001), suggesting besides VEGF-A, VEGF-B is another contributor to ocular pathologies involving angiogenesis. There was no correlation between vitreous and serum VEGF-A or VEGF-B; however, a correlation between vitreous (VEGF-A or VEGF-B) and macular volume (p < .05) in DR patients was found. Targeting VEGF-A and VEGF-B in macular and retinal vascular diseases, involving neovascularization, may improve treatment outcomes.
Clinical Ophthalmology, 2012
Background: Diabetic retinopathy is a serious microvascular disorder of the retina. Vascular endothelial growth factor (VEGF) expression, induced by high glucose levels and hypoxia, is a main feature in retinopathy. The aim of this study was to evaluate the relationship between vitreous and serum VEGF levels and control of diabetes and microalbuminuria in patients with proliferative diabetic retinopathy. Methods: Sixty-five patients were enrolled in this case-control study, comprising 30 patients with proliferative diabetic retinopathy (cases) and 35 patients with nonproliferative diabetic retinopathy (controls). The vitreous VEGF level was compared with the serum VEGF level in both groups. Glycosylated hemoglobin (HbA 1c ), microalbuminuria, serum creatinine, and stage of nephropathy and retinopathy were also measured in patients with proliferative diabetic retinopathy, and the relationship between these parameters and serum and vitreous VEGF levels was investigated. Results: Mean vitreous and serum VEGF levels were significantly higher in cases compared with controls (P = 0.001, P = 0.011, respectively). There was also a significant correlation between vitreous and serum VEGF levels (P = 0.012, r = 0.453). VEGF levels in patients with well controlled blood glucose (P = 0.039), on drug treatment (P = 0.045) and at an early stage of nephropathy (P = 0.042) were significantly lower. There was a significant correlation between VEGF and albumin to creatinine ratio (P = 0.017, r = 0.432). Conclusion: Serum and vitreous VEGF levels was significantly lower in patients on oral therapy, in those with well controlled glycemia, and in those with early-stage retinopathy. Administration of anti-VEGF had a good effect in reducing the progression of proliferative diabetic retinopathy.
Vascular Endothelial Growth Factor Level in the Serum of Diabetic Patients with Retinopathy
Annals of Ophthalmology, 2007
We determined serum levels of vascular endothelial growth factor (VEGF) at different stages of diabetic retinopathy before laser photocoagulation in 65 patients (31 nonproliferative (Group 1) and 34 proliferative (Group 2)) and in healthy controls (Group 3). VEGF levels in all groups were different. There was a significant correlation between VEGF concentration and HbA1c levels. VEGF may be involved in the prediction of diabetic retinopathy and contributes to endothelial damage in diabetics.
Pro- and antiangiogenic VEGF and its receptor status for the severity of diabetic retinopathy
Molecular vision, 2017
Alteration of pro- and antiangiogenic homeostasis of vascular endothelial growth factor (VEGF) isoforms in patients with hyperglycemia seems crucial but substantially unexplored at least quantitatively for diabetic retinopathy (DR). Therefore, in the present study we aimed to estimate the difference between the pro- (VEGFa) and antiangiogenic (VEGFb) VEGF isoforms and its soluble receptors for severity of DR. The study included 123 participants (diabetic retinopathy: 81, diabetic control: 20, non-diabetic control: 22) from the Regional Institute of Ophthalmology, Kolkata. The protein levels of VEGFa (proangiogenic), VEGFb (antiangiogenic), VEGF receptor 1 (VEGFR1), VEGFR2, and VEGFR3 in plasma were determined with enzyme-linked immunosorbent assay (ELISA). An imbalance in VEGF homeostasis, a statistically significant concomitant increase (p<0.0001) in the level of VEGFa and a decrease in the level of VEGFb, was observed with the severity of the disease. Increased differences betw...
Role of intravitreal Anti-VEGF as an adjunct in neovascular glaucoma management Contributors
IOSR Journals , 2019
Aim: To study the role of intravitreal Anti-VEGF as an adjunct in medical & surgical management of neovascular glaucoma. Methods: this hospital based interventional study was conducted on 50 patients, with the clinical presentation suggestive of neovascular glaucoma, after an extensive clinical evaluation. Intravitreal Anti-VEGF was given and the effect was recorded on subsequent follow up. Panretinal photocoagulation was done as soon as media clarity permitted. In refractory cases, trabeculectomy with mitomycin C was done Results: The common mechanism of neovascular glaucoma was CRVO (60%) and PDR (40%).Mean age was 58.44 years. There was a significant improvement in visual acuity (p= 0.0015) and intraocular pressure (IOP) (p=0.0000) at the end of 16 week follow up. There was significant regression in neovascularization of Iris/angle. Pupil size was significantly improved (p=0.0000), allowing better visualization of fundus. Out of 50 cases, surgery was required in only 18 cases. Success rate of surgery was 83.3%. Conclusion: There is a significant regression of neovascularization in NVG secondary to PDR and CRVO and this regression is stable when the underlying disease is treated well with effective suppression of ischaemic angiogenic factors. Overall, anti-VEGF agents appear very effective in inducing rapid initial regression of ischemia induced ocular neovascularization, but the effect is temporary and requires either additional definitive treatment (such as laser photocoagulation and surgery). Clinical significance: early diagnosis and proper treatment can help to save the useful vision as NVG itself is very devastating condition for eye.
VEGF localisation in diabetic retinopathy
British Journal of Ophthalmology, 1998
Aim-To determine the staining pattern of vascular endothelial growth factor (VEGF) at diVerent stages of diabetic retinopathy (including post-laser photocoagulation) and to compare staining in excised fibrovascular and fibrocellular (non-diabetic) preretinal membranes. Methods-Immunohistochemical localisation of VEGF, using antibodies raised against VEGF 165 and VEGF 121,165,189 , was carried out on specimens of normal human retina (n=15), diabetic retinas ((a) with no overt retinopathy (n=19), (b) with intraretinal vascular abnormalities but no proliferative retinopathy (n=6), (c) with active proliferative retinopathy (n=6), (d) with no residual proliferative retinopathy after photocoagulation therapy (n=15)), excised diabetic fibrovascular membranes (n=19), and non-diabetic fibrocellular membranes (n=7). The degree and pattern of immunostaining was recorded. Results-In general, VEGF was absent from the majority of normal retinas. VEGF staining was apparent in most diabetic tissues but the staining pattern was dependent on both the specificity of the antibody used and the category of tissue. Staining with the VEGF 165 antibody was generally confined to endothelial cells and perivascular regions while the VEGF 121,165,189 antibody was also associated with extravascular components of the inner retina. Intensity of immunostaining of diabetic eyes was dependent on the severity of retinopathy being least in diabetics with no overt retinopathy and greatest in retinas with proliferative retinopathy. Interestingly, the intensity of immunostaining in diabetic retinas which had undergone laser surgery for proliferative retinopathy was reduced to basal levels. Moderate to intense immunostaining was observed in all fibrovascular and fibrocellular membranes examined. Conclusions-This study supports a circumstantial role for VEGF in the pathogenesis of both the preclinical and proliferative stages of diabetic retinopathy.