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Shamim Ahmed Haji, Sandeep Grover, Balaiya Sankarathi, Kakarla V Chalam, ; Aqueous VEGF levels in Retinal Vascular Occlusion (RVO) before and after Intravitreal injection of Bevacizumab Correlate with Visual Acuity and Macular Thickness. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3917.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate levels of VEGF in the aqueous humor of patients with RVO before and after IVB and its correlation to visual acuity and central macular thickness (CMT)
10 patients with RVO were included in the study. Of the total 10 patients, 6 had CRVO and 4 BRVO. All patients received IVB at monthly interval. VEGF levels of aqueous humor were measured prior to the injection, at 1 month and 6 month intervals. VEGF estimation was done using Luminex, a commercially available cytometric bead-based assay and enzyme-linked immunosorbent assay. BSCVA and OCT measurements were assessed during the corresponding intervals.
The mean VEGF level was 24828.05 ± 5675.84 pg/ml, 20022.96 ± 3660.04 pg/ml, and 20372.84 ± 5112.49 pg/ml at baseline, 1 month and at 6 months respectively. Lower levels of VEGF were found at 1 month interval compared to baseline after IVB with mean difference of 4367.36 ± 6310.42 pg/ml, which was statistically significant (p=0.02). VEGF levels further declined at 6 month interval with mean difference of 1990.78 ± 6785.23 pg/ml , however it was not statistically significant (p=0.44). Visual acuity improved with baseline mean of 20/200 to 20/50 at 6 month interval. The improvement in visual acuity directly correlated with the decrease in VEGF level (r=0.60) The mean central macular thickness (CMT) was 436 ± 167 μm, 295 ± 44 μm, and 340 ± 100 μm at baseline, 1 month and at 6 month interval respectively. At 1 month interval, CMT decreased with a mean difference of 148 ± 193 μm (p=0.02) from baseline, which was maintained at 6 month interval (mean difference 26 ± 107 μm, (p=0.3). The decrease in CMT directly correlated with the decrease in VEGF levels (r=0.97).
Lower levels of VEGF were found at 1 month after 1st injection of IVB and remained low after 6 months, which directly correlated with the improvement of visual acuity and decrease in CMT. Aqueous humor levels of VEGF can be used to monitor the response of IVB treatment in patients with RVO
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