Zhou Huiying, Zhao Xinyu, Wang Shuran, Chen Youxin
Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Ophthalmol Ther. 2023 Apr;12(2):827-837. doi: 10.1007/s40123-022-00618-4. Epub 2022 Dec 20.
Anti-vascular endothelial growth factor (anti-VEGF) injection was widely used in patients with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV); however, the systemic and local levels of vascular endothelial growth factor (VEGF)-B were seldom detected before. This study was conducted to detect and compare the aqueous humor and plasma VEGF-B levels in nAMD and PCV before and after anti-VEGF therapy.
Concentrations of VEGF-B in aqueous humor and plasma of individuals with nAMD (n = 10), PCV (n = 22), and age-related cataract controls (n = 12) were measured by enzyme-linked immunosorbent assay. Ranibizumab was injected intravitreally in patients monthly for three consecutive months. Before each injection in patients and at the baseline of controls, blood and aqueous humor samples were collected. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were collected before each injection in patient groups. The differences of BCVA, CRT, and VEGF-B levels in aqueous humor and plasma between groups before and after anti-VEGF therapy were compared.
VEGF-B was overexpressed in aqueous humor and plasma of nAMD and PCV groups compared with control group (P < 0.05), but no statistically significant difference existed across nAMD and PCV groups (P > 0.05). Moreover, there were no obvious difference in levels of VEGF-B in aqueous humor and plasma within the treatment groups after anti-VEGF treatment (P > 0.05). The mean CRT in the nAMD group was thinner than that in the PCV group at baseline (P < 0.01). After injections, the CRT obviously declined in both groups (P < 0.05). There was no correlation between CRT reduction and high VEGF-B expression in aqueous humor and plasma of treatment groups.
Overexpression of VEGF-B locally and systemically in patients with nAMD and PCV indicated that elevated VEGF-B concentrations were relevant to the disease processes. Ranibizumab did not influence the levels of VEGF-B in the real world. CRT might help to distinguish PCV from nAMD.
抗血管内皮生长因子（anti-VEGF）注射剂广泛应用于新生血管性年龄相关性黄斑变性（nAMD）和息肉状脉络膜血管病变（PCV）患者；然而，此前很少检测血管内皮生长因子（VEGF）-B的全身和局部水平。本研究旨在检测和比较抗VEGF治疗前后nAMD和PCV患者房水和血浆中VEGF-B的水平。
采用酶联免疫吸附测定法测量nAMD患者（n = 10）、PCV患者（n = 22）和年龄相关性白内障对照组（n = 12）的房水和血浆中VEGF-B的浓度。患者每月玻璃体腔内注射雷珠单抗，连续注射三个月。在患者每次注射前以及对照组基线时，采集血液和房水样本。在患者组每次注射前采集最佳矫正视力（BCVA）和中心视网膜厚度（CRT）。比较抗VEGF治疗前后各组间BCVA、CRT以及房水和血浆中VEGF-B水平的差异。
与对照组相比，nAMD组和PCV组的房水和血浆中VEGF-B过表达（P < 0.05），但nAMD组和PCV组之间无统计学显著差异（P > 0.05）。此外，抗VEGF治疗后治疗组房水和血浆中VEGF-B水平无明显差异（P > 0.05）。基线时，nAMD组的平均CRT比PCV组薄（P < 0.01）。注射后，两组的CRT均明显下降（P < 0.05）。治疗组房水和血浆中CRT降低与高VEGF-B表达之间无相关性。
nAMD和PCV患者局部和全身VEGF-B过表达表明VEGF-B浓度升高与疾病进程相关。在实际应用中，雷珠单抗不影响VEGF-B水平。CRT可能有助于区分PCV和nAMD。
