Abstract
Purpose:
To investigate the dynamic change of VEGF and its soluble receptors in the aqueous humor during the treatment of aflibercept in patients with age-related macular degeneration (ARMD)
Methods:
Ten eyes of 10 patients with ARMD without any previous treatments were enrolled in this study and applied initial 3 monthly and additional 1 injections of aflibercept. Before each injection, aqueous humor was aspirated to prevent an increase of intraocular pressure, and the concentration of VEGF, soluble VEGF receptor-1 and -2 (sVEGFR-1, -2) in the aqueous humor was measured. Aqueous humor in the normal age-matched control subjects (n=10) were also collected at the time of cataract surgery. Central foveal thickness (CFT) and logMAR visual acuity (VA) in the eligible ARMD patients were also monitored.
Results:
During the clinical course, both CFT and VA were improved in all the eyes. At the initial injection, aqueous concentrations of VEGF was 47.8±27.6 pg/ml which was significantly higher than that obtained from control subjects. Aqueous sVEGFR-1, and sVEGFR-2 were 1.84±1.66, and 0.44±0.04 ng/ml, both of which showed no significant difference from the control ones. During the treatment of aflibercept, VEGF concentration was significantly decreased with time to 2.9±3.6 pg/ml at last visit, while both sVEGFR-1 and sVEGFR-2 were significantly increased with time to 54.9±7.2, and 2.5±0.56 ng/ml.
Conclusions:
In ARMD patients, intravitreous injection of aflibercept not only reduce the aqueous concentrations of VEGF, but increase those of sVEGFR-1 and sVEGFR-2. Thus aflibercept affects the intraocular expression of VEGF receptors.
Keywords: 490 cytokines/chemokines •
412 age-related macular degeneration •
427 aqueous