Noma Hidetaka, Mimura Tatsuya, Yasuda Kanako, Shimura Masahiko
*Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Hachiouji, Tokyo, Japan; and †Department of Ophthalmology, Medical Center East, Tokyo Women's Medical University, Arakawa-ku, Tokyo, Japan.
Retina. 2016 Sep;36(9):1718-25. doi: 10.1097/IAE.0000000000000983.
To investigate changes in the aqueous humor levels of 11 factors/cytokines (including vascular endothelial growth factor [VEGF] receptors, growth factors, and inflammatory factors) after intravitreal injection of bevacizumab (IVB), as well as the relationship between changes of these factors and improvement of macular edema in patients with branch retinal vein occlusion and macular edema.
In 29 patients with branch retinal vein occlusion who received IVB twice for macular edema at monthly intervals, aqueous humor samples were obtained during IVB. Levels of VEGF, soluble VEGF receptor (sVEGFR)-1, sVEGFR-2, placental growth factor, soluble intercellular adhesion molecule-1, monocyte chemotactic protein 1, platelet-derived growth factor-AA, and interleukin (IL)-6, IL-8, IL-12 (p70), and IL-13 were measured by the suspension array method. Foveal thickness was examined by optical coherence tomography before and 1 month after IVB, and the improvement of macular edema was evaluated by calculating the percent change of foveal thickness.
Aqueous humor levels of sVEGFR-1, VEGF, monocyte chemotactic protein 1, and IL-6 showed a significant decrease at 1 month after IVB compared with baseline (P = 0.013, P < 0.001, P = 0.047, and P = 0.019, respectively). There was a significant negative correlation between the change of sVEGFR-1 or platelet-derived growth factor-AA after IVB and the improvement of macular edema (P = 0.004 and P = 0.036, respectively).
These findings suggest that improvement of macular edema by IVB is related to inhibition of sVEGFR-1 and platelet-derived growth factor-AA, but not VEGF, in patients with branch retinal vein occlusion. Soluble VEGF receptor-1 and platelet-derived growth factor-AA might be useful indicators of the response of macular edema.
研究玻璃体内注射贝伐单抗（IVB）后房水中11种因子/细胞因子（包括血管内皮生长因子[VEGF]受体、生长因子和炎症因子）水平的变化，以及这些因子变化与视网膜分支静脉阻塞合并黄斑水肿患者黄斑水肿改善之间的关系。
对29例因黄斑水肿接受每月1次、共2次IVB治疗的视网膜分支静脉阻塞患者，在IVB期间采集房水样本。采用悬浮芯片法检测VEGF、可溶性VEGF受体（sVEGFR）-1、sVEGFR-2、胎盘生长因子、可溶性细胞间黏附分子-1、单核细胞趋化蛋白1、血小板衍生生长因子-AA以及白细胞介素（IL）-6、IL-8、IL-12（p70）和IL-13的水平。在IVB前及IVB后1个月通过光学相干断层扫描检查黄斑中心凹厚度，并通过计算黄斑中心凹厚度的变化百分比评估黄斑水肿的改善情况。
与基线相比，IVB后1个月时sVEGFR-1、VEGF、单核细胞趋化蛋白1和IL-6的房水水平显著降低（分别为P = 0.013、P < 0.001、P = 0.047和P = 0.019）。IVB后sVEGFR-1或血小板衍生生长因子-AA的变化与黄斑水肿的改善之间存在显著负相关（分别为P = 0.004和P = 0.036）。
这些发现表明，对于视网膜分支静脉阻塞患者，IVB改善黄斑水肿与抑制sVEGFR-1和血小板衍生生长因子-AA有关，而非VEGF。可溶性VEGF受体-1和血小板衍生生长因子-AA可能是黄斑水肿反应的有用指标。
