Zhang Yunda, Gao Zhao, Zhang Ximei, Yuan Zhigang, Ma Tao, Li Gaiyun, Gao Xiaohong
Department of Vitreoretinopathy, Shanxi Eye Hospital, Taiyuan, Shanxi 030002, P.R. China.
Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China.
Exp Ther Med. 2021 Apr;21(4):332. doi: 10.3892/etm.2021.9763. Epub 2021 Feb 8.
The present study aimed to investigate the mechanisms of anti-VEGF treatment prior to eye surgery to reduce intraoperative bleeding. A total of 30 patients with proliferative vitreoretinopathy after clinical diagnosis were enrolled in the present study as the surgical group. Furthermore, 30 patients underwent intravitreal injection of the anti-VEGF drug conbercept and were considered the drug pretreatment group. The aqueous and vitreous humors from the eyes of patients in the surgical group were drawn during pars plana vitrectomy surgery. The aqueous humor in the eyes of patients in the drug pretreatment group was drawn prior to conbercept treatment and seven days after conbercept treatment immediately prior to surgery. The vitreous humor in this group was only taken during surgery. Furthermore, ELISA was used to detect the levels of VEGF-A and -B in the aqueous and vitreous humors. Semi-quantitative determination of VEGF-A and VEGF-B levels in fibrovascular proliferative membranes was performed using immunohistochemical staining. The results indicated that in the drug group, the levels of VEGF-A in the aqueous humor of patients prior to and after conbercept injection were 197.66±48.00 and 3.39±2.54 pg/ml, respectively. The levels of VEGF-A in the vitreous humor of patients in the surgical and drug groups were 267.53±179.60 and 21.43±5.81 pg/ml after injection, respectively. The levels of VEGF-B in the aqueous humor of patients prior to and after conbercept injection were 13.66±3.30 (before injection) and 2.17±0.94 pg/ml (after injection), respectively. The levels of VEGF-B in the vitreous humor of patients in the surgical and drug groups were 127.36±16.72 and 18.56±9.82 pg/ml after injection, respectively (P<0.05). Furthermore, in the drug group, the surgery time, bleeding and capillary formation were significantly reduced compared with those in the surgical group. Taken together, these results suggested that the levels of VEGF-A and -B decreased significantly in the aqueous humor of patients with PDR after conbercept injection. Furthermore, the levels of VEGF-A and -B in the vitreous humor of patients dropped significantly in the drug group compared with those in the surgical group. These results provide theoretical clinical support for the preoperative application of conbercept for patients with PDR.
本研究旨在探讨眼科手术前抗血管内皮生长因子(VEGF)治疗减少术中出血的机制。本研究共纳入30例经临床诊断为增殖性玻璃体视网膜病变的患者作为手术组。此外,30例患者接受了玻璃体内注射抗VEGF药物康柏西普,并被视为药物预处理组。手术组患者在玻璃体切割手术期间抽取眼内的房水和玻璃体。药物预处理组患者在康柏西普治疗前以及康柏西普治疗后7天手术前立即抽取房水。该组患者的玻璃体仅在手术期间采集。此外,采用酶联免疫吸附测定(ELISA)检测房水和玻璃体中VEGF-A和VEGF-B的水平。使用免疫组织化学染色对纤维血管增殖膜中VEGF-A和VEGF-B水平进行半定量测定。结果表明,在药物组中,康柏西普注射前后患者房水中VEGF-A水平分别为197.66±48.00和3.39±2.54 pg/ml。手术组和药物组患者注射后玻璃体中VEGF-A水平分别为267.53±179.60和21.43±5.81 pg/ml。康柏西普注射前后患者房水中VEGF-B水平分别为13.66±3.30(注射前)和2.17±0.94 pg/ml(注射后)。手术组和药物组患者注射后玻璃体中VEGF-B水平分别为127.36±16.72和18.56±9.82 pg/ml(P<0.05)。此外,在药物组中,与手术组相比,手术时间、出血量和毛细血管形成均显著减少。综上所述,这些结果表明,康柏西普注射后糖尿病性视网膜病变(PDR)患者房水中VEGF-A和VEGF-B水平显著降低。此外,与手术组相比,药物组患者玻璃体中VEGF-A和VEGF-B水平显著下降。这些结果为康柏西普在PDR患者术前应用提供了理论临床支持。