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Tania Basaiawmoit, Ashwin Mohan, Naresh Kumar Yadav; Role of aqueous vascular endothelial growth factor (VEGF) assay in macular edema secondary to retinal venous occlusions (RVO)-A Pilot Study. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3736.
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A prospective pilot study was done to assess the role of aqueous VEGF levels in macular edema following retinal vein occlusions.We also used the levels as a guide to tailor our treatment in select cases based on the aqueous VEGF levels,thus,helping us provide the patients with the best treatment option available to them.
25 eyes of 25 patients were included in the study.15 being cases and 10 controls.The inclusion criteria were central or branch RVO with cystoid macular edema detected on OCT not having undergone any treatment,laser or anti VEGF injections within 3 months of presentation.Patients with combined retinopathy,neovascular glaucoma or any signs of ocular inflammation were excluded from the study.Aqueous VEGF assay using BDTMCytometric Bead Array,Human VEGF Flex Set were done in all patients.1 month post injection of anti VEGF visual acuity and central foveal thickness(CFT) were reassessed.Based on the patients’ aqueous VEGF levels and response to the 1st dose of IVB,treatment was tailored for individual patients and their response to the modified treatment 1 month thereafter was measured.Correlation (Pearson's r) between macular thickness and VEGF levels were calculated using the Correl function in Microsoft Excel and results obtained were presented as the mean (SD). Correlation between VEGF in CRVO and BRVO were calculated using the Mann Whitney test.
The mean VEGF level and CFT were 295.13 pg/ml and 911µ respectively in the CRVO group. The BRVO group had a mean VEGF and CFT level of 27.9 pg/ml and 572µ respectively.A statistically significant difference (p=0.026) in aqueous levels of VEGF was found in the CRVO group as compared to the controls and the BRVO group.There was no significant difference in CFT between the CRVO and BRVO group.(p=0.19)Taking p to be significant and < 0.1,a weak correlation (R= 0.453; p = 0.0902) was found to exist between aqueous VEGF levels and macular edema.Improvement in visual acuity and CFT was seen in 86.4%(p = 0.0015) and 73.3 % (p= 0.07) of the patients respectively.
Patients with macular edema treated with anti VEGF’s exhibited anatomical and functional improvement.Aqueous VEGF levels had no uniform correlation with CFT.Aqueous sampling for more cytokines other than VEGF will help us better understand the pathophysiology of RVOs and guide us in selecting treatment for the same
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