Suzuki Yukihiko, Suzuki Kaori, Kudo Takashi, Metoki Tomomi, Nakazawa Mitsuru
Department of Ophthalmology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
Ophthalmologica. 2016;236(3):133-138. doi: 10.1159/000449261. Epub 2016 Oct 29.
The aim of this study was to evaluate the relationship between the intravitreal vascular endothelial growth factor (VEGF) level and prognosis of proliferative diabetic retinopathy (PDR).
The study involved 136 eyes of 114 PDR patients who underwent an initial vitrectomy between 2006 and 2008. Intravitreal VEGF levels were determined using Bio-Plex® (Bio-Rad), with levels of 5,000 pg/mL or more classified as high-VEGF (45 eyes) and levels lower than 5,000 pg/mL as low-VEGF (91 eyes). Diabetic control, PDR severity, and frequency of postoperative complications were compared between the groups.
There was no significant difference in preoperative status between the groups. In the low-VEGF group, a reoperation was required due to postoperative complications in 2 eyes (2.2%); 1 with vitreous hemorrhage (VH) and 1 with retinal detachment (RD). In contrast, a reoperation was required in 8 eyes (17.8%) in the high-VEGF group; 3 with VH, 2 with RD, and 3 with neovascular glaucoma. The difference between the groups was significant. There was a statistically lower postoperative corrected visual acuity logMAR (6 months after surgery) in the high-VEGF than in the low-VEGF group (p = 0.02, unpaired t test).
Current findings indicate that careful observation is needed in patients with elevated VEGF levels.
本研究旨在评估玻璃体内血管内皮生长因子（VEGF）水平与增殖性糖尿病视网膜病变（PDR）预后之间的关系。
本研究纳入了2006年至2008年间接受初次玻璃体切除术的114例PDR患者的136只眼。使用Bio-Plex®（伯乐公司）测定玻璃体内VEGF水平，5000 pg/mL及以上的水平归类为高VEGF（45只眼），低于5000 pg/mL的水平归类为低VEGF（91只眼）。比较两组之间的糖尿病控制情况、PDR严重程度和术后并发症发生率。
两组术前状况无显著差异。在低VEGF组中，2只眼（2.2%）因术后并发症需要再次手术；1只眼发生玻璃体积血（VH），1只眼发生视网膜脱离（RD）。相比之下，高VEGF组有8只眼（17.8%）需要再次手术；3只眼发生VH，2只眼发生RD，3只眼发生新生血管性青光眼。两组之间的差异具有显著性。高VEGF组术后矫正视力logMAR（术后6个月）在统计学上低于低VEGF组（p = 0.02，非配对t检验）。
目前的研究结果表明，VEGF水平升高的患者需要密切观察。
