Nisic Faruk, Jovanovic Nina, Mavija Milka, Alimanovic-Halilovic Emina, Nisic Aida, Lepara Orhan, Cemerlic Adem
Clinic for Eye Disease, Clinical Centre University Sarajevo, Sarajevo, Bosnia and Herzegovina.
Ophthalmology Department, Canton Hospital Zenica, Zenica, Bosnia and Herzegovina.
Arch Med Sci. 2019 Mar;15(2):449-456. doi: 10.5114/aoms.2018.73208. Epub 2018 Feb 2.
The aim of the study was to investigate the effects of vascular endothelial growth factor (VEGF) concentration in vitreous on postoperative complications after pars plana vitrectomy (PPV).
Ninety subjects were surgically treated with PPV and followed up for 12 months at the Clinical Centre University Sarajevo, Clinic for Eye Disease. Exclusion criteria were presence of other eye diseases, systemic acute/chronic inflammatory conditions, or malignant neoplasms; previously performed PPV surgery; previously received intravitreal or systemic anti-VEGF therapy. A vitreous sample was obtained while performing the PPV procedure, using the Quantikine ELISA test to determine VEGF level, as a risk factor. Outcome measures were intraoperative and postoperative complications reported using categorical data: blunt and sharp dissection of membranes, intraoperative hemorrhage stopped by increasing infusion pressure, pressing with blunt instrument, or using diathermy. The following postoperative complications were assessed on the first day and at the 12-month follow-up visit: vitreous hemorrhage, fibrovascular proliferation (FVP), rubeosis iridis, and neovascular glaucoma (NVG).
Levels of vitreous VEGF at the time of PPV were significantly higher in eyes with: vitreous hemorrhage on the first day after PPV ( = 0.003); FVP on the first day and 12 months after PPV ( = 0.002 and < 0.001, respectively); iris rubeosis on the first day and 12 months after PPV surgery ( < 0.001, and = 0.001, respectively); NVG on the first day and 12 months after PPV surgery ( = 0.043 and = 0.011, respectively), compared to the eyes without complications.
Preoperative levels of VEGF in vitreous can be a useful biomarker and predictor of the postoperative outcome in terms of intraoperative and postoperative complications.
本研究的目的是探讨玻璃体中血管内皮生长因子（VEGF）浓度对玻璃体切割术（PPV）术后并发症的影响。
90名受试者在萨拉热窝大学临床中心眼科诊所接受了PPV手术，并随访12个月。排除标准为存在其他眼部疾病、全身性急/慢性炎症性疾病或恶性肿瘤；既往接受过PPV手术；既往接受过玻璃体内或全身性抗VEGF治疗。在进行PPV手术时获取玻璃体样本，使用Quantikine ELISA检测法测定VEGF水平，将其作为一个危险因素。结果指标为使用分类数据报告的术中及术后并发症：膜的钝性和锐性分离、通过增加输注压力、用钝性器械按压或使用透热法止血的术中出血。在术后第1天和12个月随访时评估以下术后并发症：玻璃体积血、纤维血管增殖（FVP）、虹膜新生血管和新生血管性青光眼（NVG）。
与无并发症的眼睛相比，PPV时玻璃体VEGF水平在以下情况的眼中显著更高：PPV术后第1天出现玻璃体积血（P = 0.003）；PPV术后第1天和12个月出现FVP（分别为P = 0.002和P < 0.001）；PPV术后第1天和12个月出现虹膜新生血管（分别为P < 0.001和P = 0.001）；PPV术后第1天和12个月出现NVG（分别为P = 0.043和P = 0.011）。
玻璃体中VEGF的术前水平在术中及术后并发症方面可以作为一个有用的生物标志物和术后结果的预测指标。
