Hata Masayuki, Yamashiro Kenji, Ooto Sotaro, Oishi Akio, Tamura Hiroshi, Miyata Manabu, Ueda-Arakawa Naoko, Takahashi Ayako, Tsujikawa Akitaka, Yoshimura Nagahisa
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Department of Ophthalmology, Kagawa University Faculty of Medicine, Miki, Japan.
Invest Ophthalmol Vis Sci. 2017 Jan 1;58(1):292-298. doi: 10.1167/iovs.16-20967.
To investigate the difference in intraocular vascular endothelial growth factor (VEGF) concentration between pachychoroid neovasculopathy and neovascular age-related macular degeneration (nAMD) and its associations with responses to three monthly anti-VEGF injections as an initial treatment for the two conditions.
This study included nine eyes with treatment-naïve pachychoroid neovasculopathy and 21 eyes with treatment-naïve nAMD. Before the initial intravitreal anti-VEGF injection, aqueous humor samples were collected and the concentration of VEGF was measured using enzyme-linked immunosorbent assay. The concentration was compared between the two conditions, and its associations with responses to anti-VEGF therapy were investigated.
The mean VEGF concentration in pachychoroid neovasculopathy was significantly lower than that in nAMD (63.4 ± 17.8 pg/ml and 89.8 ± 45.0 pg/ml, respectively; P = 0.035). The VEGF concentration was associated with the presence or absence of drusen (β = 0.503, P = 0.004). After anti-VEGF therapy, 6 (66.7%) of 9 eyes with pachychoroid neovasculopathy and 17 (81.0%) of 21 eyes with nAMD achieved dry macula (P = 0.640). Dry macula at 3 months and 12 months was significantly associated with a low VEGF concentration in pachychoroid neovasculopathy (P = 0.013 and P = 0.042, respectively), but not in nAMD (P = 0.108 and P = 0.219).
The mean VEGF concentration in pachychoroid neovasculopathy was lower than that in nAMD, suggesting that the way in which VEGF is involved in angiogenesis may differ between pachychoroid neovasculopathy and nAMD.
研究厚脉络膜新生血管病变与新生血管性年龄相关性黄斑变性（nAMD）患者眼内血管内皮生长因子（VEGF）浓度的差异，及其与两种疾病初次治疗时每月3次抗VEGF注射反应的相关性。
本研究纳入9例未经治疗的厚脉络膜新生血管病变患者的9只眼和21例未经治疗的nAMD患者的21只眼。在初次玻璃体腔内抗VEGF注射前，采集房水样本，采用酶联免疫吸附测定法测量VEGF浓度。比较两种疾病的VEGF浓度，并研究其与抗VEGF治疗反应的相关性。
厚脉络膜新生血管病变患者的平均VEGF浓度显著低于nAMD患者（分别为63.4±17.8 pg/ml和89.8±45.0 pg/ml；P = 0.035）。VEGF浓度与玻璃膜疣的有无相关（β = 0.503，P = 0.004）。抗VEGF治疗后，9例厚脉络膜新生血管病变患者中的6例（66.7%）和21例nAMD患者中的17例（81.0%）黄斑区实现了干性愈合（P = 0.640）。在厚脉络膜新生血管病变中，3个月和12个月时黄斑区干性愈合与低VEGF浓度显著相关（分别为P = 0.013和P = 0.042），但在nAMD中无此相关性（P = 0.108和P = 0.219）。
厚脉络膜新生血管病变患者的平均VEGF浓度低于nAMD患者，提示VEGF参与血管生成的方式在厚脉络膜新生血管病变和nAMD之间可能存在差异。
