玻璃体腔内注射贝伐单抗、阿柏西普或雷珠单抗治疗糖尿病性黄斑水肿后血浆血管内皮生长因子水平的变化。

CHANGES IN PLASMA VASCULAR ENDOTHELIAL GROWTH FACTOR LEVEL AFTER INTRAVITREAL INJECTION OF BEVACIZUMAB, AFLIBERCEPT, OR RANIBIZUMAB FOR DIABETIC MACULAR EDEMA.

机构信息

Department of Ophthalmology, School of Medicine, Shinshu University, Matsumoto, Japan.

出版信息

Retina. 2018 Sep;38(9):1801-1808. doi: 10.1097/IAE.0000000000002004.

PURPOSE

The aim of this study was to investigate the changes in plasma vascular endothelial growth factor (VEGF) level depending on the severity of diabetic retinopathy (DR) or diabetic macular edema (DME) and after intravitreal injection of bevacizumab, aflibercept, or ranibizumab for treatment of DME.

METHODS

Plasma VEGF level was evaluated in 72 patients with DR and changes were measured in 42 patients with DME receiving intravitreal injections of bevacizumab, aflibercept, or ranibizumab at the initial injection.

RESULTS

There were no correlations between plasma VEGF level and the severity of DME or DR. Baseline plasma VEGF level (51.9 pg/mL) was significantly reduced using bevacizumab to 11.9 pg/mL after 1 week and 24.1 pg/mL after 4 weeks (P = 0.0130 and 0.0201, respectively). In aflibercept-treated eyes, plasma VEGF decreased from 52.2 pg/mL to 7.8 pg/mL and 12.6 pg/mL, respectively, at the same time points (both P < 0.001). No such reductions were observed in patients receiving ranibizumab.

CONCLUSION

Baseline plasma VEGF level showed no correlations with DR or DME severity, whereas intravitreal injection of bevacizumab or aflibercept significantly reduced plasma VEGF for up to 4 weeks and ranibizumab produced no such effects. Changes in plasma VEGF level seemed not to be critical in progression or treatment of DME and DR.

目的

本研究旨在探讨根据糖尿病视网膜病变（DR）或糖尿病黄斑水肿（DME）的严重程度以及玻璃体内注射贝伐单抗、阿柏西普或雷珠单抗治疗 DME 后，血浆血管内皮生长因子（VEGF）水平的变化。

方法

评估了 72 例 DR 患者的血浆 VEGF 水平，并在 42 例接受玻璃体内注射贝伐单抗、阿柏西普或雷珠单抗治疗的 DME 患者中测量了治疗后的变化。

结果

血浆 VEGF 水平与 DME 或 DR 的严重程度之间无相关性。基线时，贝伐单抗治疗后 1 周和 4 周时血浆 VEGF 水平（51.9 pg/mL）分别显著降低至 11.9 pg/mL 和 24.1 pg/mL（P = 0.0130 和 0.0201）。阿柏西普治疗后，血浆 VEGF 分别从 52.2 pg/mL 降低至 7.8 pg/mL 和 12.6 pg/mL，在相同时间点均有显著差异（均 P < 0.001）。而接受雷珠单抗治疗的患者则无此变化。