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Farshad Abedi, Sanjeewa Wickremasinghe, Amirul Islam, Robyn H Guymer; VEGF levels in serum and the outcome of intravitreal anti-VEGF treatment in neovascular age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):592.
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To investigate the association of baseline vascular endothelial growth factor (VEGF) level in serum with the outcome of anti-VEGF treatment in patients with neovascular age-related macular degeneration (AMD).
97 consecutive treatment naïve patients with neovascular AMD were recruited to the study. A peripheral blood sample was obtained from all patients before the first injection. Patients were treated with 3 initial monthly ranibizumab or bevacizumab injections followed by an as needed treatment protocol for 12 months. A peripheral blood sample was obtained from 30 patients at month 3 (one month after the third injection). VEGF level was measured in the serum samples with ELISA method. A multivariate linear regression statistical model was fitted to investigate the association of baseline VEGF level with baseline visual acuity (VA) and mean change in VA after twelve months. The association of mean change in VEGF level after 3 initial monthly injections with mean change in VA after 3 and 12 months was also examined.
Mean age of patients was 77.8±6.7 years and mean baseline VA was 40.8±19.9 Early Treatment Diabetic Retinopathy Study letters scores. Our cohort consisted of 49 (50.5%) female versus 48 (49.5%) male patients. Mean change in VA after 12 months was 10.3±17.1 letters. This was achieved with, on average, 7.1±2.1 injections over 12 months. Mean baseline VEGF level was 366.9±256.5 pg/ml for all patients. In those 30 patients whose blood sample was obtained one month after the third injection, mean VEGF level significantly dropped from 357.4±240.8pg/ml to 285.7±185.4pg/ml (P=0.03). Linear regression model did not reveal any significant association for baseline VEGF levels with baseline VA (P=0.1) or change in VA after 3 months (P=0.8) or 12 months (P=0.5). Change in VEGF level from baseline after the third injection was not associated with mean change in VA after 3 months (P=0.9) or 12 months (P=0.8), either.
We couldn’t find any significant associations between baseline VEGF level or change in VEGF level from baseline after 3 initial monthly injections and the mean change in VA after 3 or 12 months.
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