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N. Ianopol, D. Ungureanu, P. S. Muether, M. Beruica, C. Fusalau, I. Cijevschi, B. Kirchhof; Effect of Bevacizumab on Intraocular VEGF in Proliferative Diabetic Retinopathy and Exudative Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1343.
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To assess intraocular levels of VEGF in response to intravitreal Bevacizumab in different stages of Proliferative Diabetic Retinopathy (PDR) and in exudative Age related Macular Degeneration (eAMD).
Aqueous humour levels of VEGF (pg/ml) were measured prior to- and 21 days post intravitreal Bevacizumab (1.25 mg/injection) by using an ELISA Kit, in different stages of activity of PDR (n=43 eyes) and in eAMD (n=10 eyes).
Aqueous humour VEGF levels were lower in controls 160.53±62.61 than in PDR 428.25±249.81 or eAMD 301.14±219.86. VEGF levels were correlated to the disease severity in PDR groups: severe PDR without severe exudation 678.19±199.23, severe PDR with severe exudation 3230.66±1935.99, moderate PDR (mPDR) 322.06±101.21, mild PDR (rPDR) 192.84±56.38. Laser treatment (LT) decreased VEGF level in PDR lasered groups: not LT mPDR 322.06±101.21 - lasered mPDR 204.8±24.29, not LT rPDR 192.84±56.38 - lasered rPDR 149.06±35.02. After 21 days, intravitreal Bevacizumab decreased intraocular VEGF levels in PDR group from 626.17±221.72 to 246.02±222.03 (p=0.016) and in eAMD group from 303.23±187.31 to 131.19±34.47 (p=0.019). However, individual values suggested that this evolution is not observed when VEGF levels are under certain limits. Compensatory mechanisms are suspected to protect VEGF.
Intraocular VEGF activity reflects disease activity. Bevacizumab decreases the intraocular VEGF levels in PDR and eAMD, possibly when VEGF exceeds a physiologic level. Further studies will correlate alterations in VEGF activity to changes in the activity of other intraocular growth factors.
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