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Dmitry Lipatov, Anatoliy Kuzmin, Timofey Chistaykov, Yulia Bautina, Marina Shestakova, department of ophthalmology of Endocrinology Reserch Center; Intraocular contents of the vascular endothelial growth factor as a marker of diabetic retinopathy progression.. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1947.
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© ARVO (1962-2015); The Authors (2016-present)
To estimate the influence of the intraocular value vascular endothelial growth factor (VEGF) to the diabetic retinopathy (DR) progression in patients with diabetes mellitus (DM) been operaed due to cataract, and to determine the power of the VEGF assessment in the anterior chamber of eye (AChE) as a diagnostic test of the proliferative DR.
420 patients with DM type 1 and type 2 been operated due to cataract (facoemulsification) were included in the study. During surgical procedure the fluids of the AChE were obtained for VEGF value analysis (by technique ELISA). All patients were surveyed under supervision of the ophthalmologist and endocrinologist before operation. Duration of the follow-up period after operation was not less than 12 months.
All patients before operation did not differ by corrected distance visual acuity (CDVA), however proliferative DR was correctly diagnosed only in 50 % of cases because of the lens opacity. The average VEGF-A level in fluid of AChE in patients with DM, but without DR sings was 22,75 pg/ml. More severe DR tended to occur in diabetic patients with higher VEGF levels in AChE. In patients with non-proliferative DR VEGF value was 52,5 pg/ml, with pre-proliferative DR - 75,84 pg/ml and in proliferative DR reached 336,6 pg/ml. The differences were statistically significant, p <0,0001. Patients with high intraocular contents of the VEGF (more, than 140 pg/ml) had the worse prognosis of the DR progression. They were treated by laser coagulation of the retina in 1,19 times than patients with VEGF value in the AChE below 140 pg/ml, and they developed anterior chamber neovascularion in 12,3 times often (p=0,0004) than otherss. Anterior chamber neovascularion led to neovascular glaucoma.
High contents of the VEGF in fluid of the AChE is the predicted factor of the DR progression. Level VEGF in the AChE more than 140 pg/ml can be an additional criterion for the deterioration of the proliferation process of the eye in patients with DM.
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