Shimada Hiroyuki, Akaza Eriko, Yuzawa Mitsuko, Kawashima Miwako
Department of Ophthalmology, School of Medicine, Nihon University, Chiyodaku, Tokyo, Japan.
Invest Ophthalmol Vis Sci. 2009 Jun;50(6):2953-5. doi: 10.1167/iovs.08-2870. Epub 2008 Dec 5.
Vascular endothelial growth factor (VEGF) concentrations in various regions of the vitreous were examined in patients with diabetic macular edema (DME) to explore the possibility of a concentration gradient in the vitreous.
Vitreous samples were collected during vitrectomy from 71 eyes of 71 patients with DME and without posterior vitreous detachment who had not undergone panretinal photocoagulation. Vitreous samples were collected from the premacular vitreous and mid-vitreous (group A, 35 eyes), and from the premacular vitreous and peripheral cortical vitreous (group B, 36 eyes). Mean foveal thickness was measured by optical coherence tomography (OCT). Ten eyes of 10 patients with stage 3 macular hole (MH) served as controls. Vitreous VEGF levels were measured by enzyme-linked immunosorbent assay.
The VEGF concentration (mean +/- SD; pg/mL) was significantly higher in the premacular vitreous (1386.2 +/- 2134.1) than in the peripheral cortical vitreous (1169.7 +/- 1840.3; P = 0.0216) and mid-vitreous (1080.9 +/- 1534.1; P = 0.0017). The mean foveal thickness measured on OCT correlated significantly with VEGF concentrations in the premacular vitreous, peripheral cortical vitreous, and mid-vitreous (R > 0.62, P < 0.0001, for all). In controls, VEGF concentrations in the premacular vitreous, peripheral cortical vitreous and mid-vitreous were all below the detection limit (<20 pg/mL).
In DME, vitreous VEGF concentration correlates with mean foveal thickness measured on OCT. VEGF concentration was higher in premacular vitreous than in mid-vitreous and peripheral cortical vitreous, suggesting diffusion from the macular region to the periphery, and from the posterior to the anterior globe.
检测糖尿病性黄斑水肿（DME）患者玻璃体不同区域的血管内皮生长因子（VEGF）浓度，以探讨玻璃体中是否存在浓度梯度。
对71例未行全视网膜光凝且无玻璃体后脱离的DME患者的71只眼进行玻璃体切割术时采集玻璃体样本。从黄斑前玻璃体和玻璃体中部采集玻璃体样本（A组，35只眼），以及从黄斑前玻璃体和周边皮质玻璃体采集样本（B组，36只眼）。通过光学相干断层扫描（OCT）测量平均黄斑中心凹厚度。10例黄斑裂孔（MH）3期患者的10只眼作为对照。采用酶联免疫吸附测定法测量玻璃体VEGF水平。
黄斑前玻璃体的VEGF浓度（平均值±标准差；pg/mL）显著高于周边皮质玻璃体（1169.7±1840.3；P = 0.0216）和玻璃体中部（1080.9±1534.1；P = 0.0017）。OCT测量的平均黄斑中心凹厚度与黄斑前玻璃体、周边皮质玻璃体和玻璃体中部的VEGF浓度显著相关（R>0.62，P<0.0001，均如此）。在对照组中，黄斑前玻璃体、周边皮质玻璃体和玻璃体中部的VEGF浓度均低于检测限（<20 pg/mL）。
在DME中，玻璃体VEGF浓度与OCT测量的平均黄斑中心凹厚度相关。黄斑前玻璃体的VEGF浓度高于玻璃体中部和周边皮质玻璃体，提示从黄斑区域向周边扩散，以及从眼球后部向前部扩散。
