Abstract
Purpose:
To investigate the relations among visual acuity, central macular thickness (CMT), recurrent times, and changes of growth factors, vascular endothelial growth factor (VEGF) receptor, and inflammatory factors, including VEGF in recurred patients after intravitreal ranibizumab (IVR) for branch retinal vein occlusion (BRVO) with macular edema.
Methods:
Thirty-one eyes with BRVO were performed IVR. After initial IVR, needed injection (PRN) of IVR was done for 6months. At the time of IVR, a mean volume of 0.1 mL of aqueous humor was collected by anterior chamber limbal paracentesis. All patients signed an informed consent form. Then the aqueous humor levels of vascular endothelial growth factor (VEGF), soluble VEGF receptor (sVEGFR)-1, sVEGFR-2, soluble intercellular adhesion molecule (sICAM)-1, monocyte chemotactic protein (MCP)-1, platelet-derived growth factor (PDGF)-AA, interleukin (IL)-6, and IL-8 were measured by the suspension array method (xMAP; Luminex Corp. Austin, TX). Macular edema was examined by optical coherence tomography and its severity was determined from the CMT.
Results:
An average of 1.7 times of additional IVR was required from initial IVR for six months (0 times, 4 patients; 1 times; 7 patients; 2 times, 14 patients; 3 times, 6 patients). There were no significant relations between improvement of visual acuity and CMT or recurred times. There were significant correlations between baseline levels of sVEGFR-1 and PDGF-AA or recurred times (P=0.047, P=0.023, respectively). The aqueous humor levels of sVEGFR-1 and PDGF-AA after IVR significantly decreased in the first recurred time and second recurred time than baseline, but increased in the third recurred time than second recurred times. On the other hand, the aqueous humor levels of VEGF, PlGF, IL-6, and IL-8 after IVR significantly decreased in the first recurred time, the second recurred time, and the third recurred time than baseline (all P<0.05).
Conclusions:
These findings suggest that sVEGFR-1 and PDGF-AA may contribute to the pathogenesis of BRVO in the patients who repeat a recurrence after IVR.