Funk Marion, Kriechbaum Katharina, Prager Franz, Benesch Thomas, Georgopoulos Michael, Zlabinger Gerhard J, Schmidt-Erfurth Ursula
Department of Ophthalmology, Medical University of Vienna, Vienna, Austria.
Invest Ophthalmol Vis Sci. 2009 Mar;50(3):1025-32. doi: 10.1167/iovs.08-2510. Epub 2008 Dec 5.
To investigate concentrations of growth factors and inflammatory cytokines in eyes with central (CRVO) and branch (BRVO) retinal vein occlusion before and during therapy with bevacizumab and to identify associations with disease activity.
In a prospective clinical trial, 13 eyes of patients with CRVO (n = 5) or BRVO (n = 8) were included. Bevacizumab was administered intravitreously at baseline and months 1 and 2. Retreatments were given at monthly visits if OCT showed edema or when vision loss occurred. Aqueous humor samples were taken each time injections were performed. Follow-up was 15 months. Samples from patients with cataract served as the control. Multiplex bead assays were used for measurement of 28 growth factors and cytokines.
During therapy with bevacizumab, VEGF levels were reduced to below detection in the first 2 months. Whenever criteria for retreatment were met, VEGF was measurable again. The decrease in VEGF was associated with a decrease in central retinal thickness (CRT) and improvement in visual acuity (VA). Significantly increased concentrations of VEGF, IL-6, IL-8, IP-10, MCP-1, and PDGF-AA were observed in aqueous humor samples of patients with CRVO compared with the control samples.
VEGF levels were significantly elevated in patients with CRVO compared with control subjects. Intravitreal injections of bevacizumab resulted in a substantial decrease of VEGF under physiologic levels and remained low under the loading dose of three consecutive monthly retreatments. Macular edema was related to VEGF levels in the aqueous humor.
研究在接受贝伐单抗治疗前及治疗期间，中心性视网膜静脉阻塞（CRVO）和分支性视网膜静脉阻塞（BRVO）患者眼内生长因子和炎性细胞因子的浓度，并确定其与疾病活动的相关性。
在一项前瞻性临床试验中，纳入了CRVO患者（n = 5）或BRVO患者（n = 8）的13只眼。在基线、第1个月和第2个月时玻璃体内注射贝伐单抗。如果光学相干断层扫描（OCT）显示有水肿或出现视力丧失，则在每月随访时进行再次治疗。每次注射时采集房水样本。随访时间为15个月。以白内障患者的样本作为对照。采用多重微珠分析方法测定28种生长因子和细胞因子。
在贝伐单抗治疗期间，VEGF水平在最初2个月内降至检测下限以下。每当达到再次治疗标准时，VEGF又可检测到。VEGF的降低与中心视网膜厚度（CRT）的减少和视力（VA）的改善相关。与对照样本相比，在CRVO患者的房水样本中观察到VEGF、IL-6、IL-8、IP-10、MCP-1和PDGF-AA的浓度显著升高。
与对照受试者相比，CRVO患者的VEGF水平显著升高。玻璃体内注射贝伐单抗导致VEGF在生理水平以下大幅下降，并且在连续3个月每月一次的再次治疗负荷剂量下仍保持较低水平。黄斑水肿与房水中的VEGF水平相关。
