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Hye Shin Jeon, Hyun Woong Kim, Sang-Joon Lee, Ji Eun E. Lee, Boo Sup Oum, Eun Sook Jun; Effect Of Systemic Angiotensin Receptor Blocker To Intravitreal Vascular Endothelial Growth Factor In Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3289.
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Renin-angiotensin system is reported to be associated with vitreous level of vascular endothelial growth factor (VEGF) in proliferative diabetic retinopathy (PDR). This study is conducted to investigate if systemic angiotensin receptor blocker (ARB) medication may reduce intravitreal VEGF concentration in PDR.
Patients who underwent vitrectomy for tractional retinal detachment or vitreous hemorrhage due to PDR were included in the study. Group A had patients who had been taking ARB for more than 3 months before vitrectomy, and group B had patients without hypertension. Patients with epiretinal membrane or macular hole were also included as control, or group C. The vitreous fluid was collected during vitrectomy and the venous blood was sampled in the same day. The serum was separated by centrifuge, and the sampled vitreous and serum were stored in -80°C. The VEGF level in vitreous fluid and serum was measured using enzyme linked immune-sorbent assay.
Among 52 patients, 19 eyes were in the group A, 30 eyes in the group B, and 30 eyes in the group C. Vitreous VEGF levels were 488.2, 559.0 and 4.5 pg/ml respectively. Serum VEGF levels were 384.8, 372.8, and 388.1. The ratio of vitreous VEGF to serum was 4.01, 3.32 and 0.03. Although vitreous VEGF levels and its vitreous to serum ratio in the PDR groups were significantly higher than in the control group (P<0.0001), there was no difference between the group A and the group B.
Systemic medication of ARB did not alter vitreous level of VEGF in PDR patients. The results of the current study suggest that systemic ARB has a limitation to improve diabetic retinopathy by modifying intraocular rennin-angiotensin system.
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