Feng Jing, Li Bing, Wen Jing, Jiang Yanrong
Department of Ophthalmology, Peking University People's Hospital, and Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China.
Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Ophthalmic Res. 2018;60(4):250-257. doi: 10.1159/000493640. Epub 2018 Oct 31.
To evaluate the changes in aqueous concentrations of inflammatory cytokines and fibrosis-related factors, and to detect the expression of vascular endothelial growth factor (VEGF) and proliferating cells in fibrovascular membranes (FVMs) of patients with proliferative diabetic retinopathy (PDR) after injection of intravitreal bevacizumab (IVB).
Forty-two eyes of 42 patients with PDR, including 28 eyes that received IVB (1.25 mg) 2, 5, and 14 days before pars plana vitrectomy (PPV), and 14 eyes without IVB, were enrolled, in addition to 10 eyes of 10 patients with nondiabetic ocular diseases. Aqueous concentrations of inflammatory cytokines and fibrosis-related factors were analyzed by a multiplex bead assay. Fluorescence immunostaining was performed to examine the expression of VEGF and proliferating cells in the excised epiretinal membranes.
PDR eyes without IVB had the highest vitreous VEGF levels, and the level was statistically significant compared with that of PDR eyes that received IVB 2 days before surgery, PDR eyes that received IVB 5 days before surgery, and nondiabetic eyes (p = 0.011, p = 0.012, and p < 0.001, respectively). The expression of fibroblastic cells and connective tissue growth factor increased in epiretinal FVMs of the IVB group 21 days after treatment.
IVB injection may lead to a decrease in the intraocular concentrations of VEGF after 2-5 days and induce the formation of proliferation after 21 days, which suggests that PPV in PDR patients should take place within 1 week of the administration of preoperative IVB.
评估增殖性糖尿病视网膜病变（PDR）患者玻璃体内注射贝伐单抗（IVB）后房水中炎性细胞因子和纤维化相关因子浓度的变化，并检测纤维血管膜（FVM）中血管内皮生长因子（VEGF）的表达及增殖细胞情况。
纳入42例PDR患者的42只眼，其中28只眼在玻璃体切割术（PPV）前2、5和14天接受IVB（1.25 mg）注射，14只眼未接受IVB注射，另外纳入10例非糖尿病性眼病患者的10只眼作为对照。采用多重微珠分析法分析房水中炎性细胞因子和纤维化相关因子的浓度。对切除的视网膜前膜进行荧光免疫染色，以检测VEGF的表达及增殖细胞情况。
未接受IVB注射的PDR眼玻璃体内VEGF水平最高，与术前2天接受IVB注射的PDR眼、术前5天接受IVB注射的PDR眼及非糖尿病眼相比，差异具有统计学意义（分别为p = 0.011、p = 0.012和p < 0.001）。治疗21天后，IVB组视网膜前FVM中成纤维细胞和结缔组织生长因子的表达增加。
IVB注射可能在2 - 5天后导致眼内VEGF浓度降低，并在21天后诱导增殖形成，这表明PDR患者的PPV应在术前IVB给药后1周内进行。
