VEGF 165 Serum Levels and Lipid Profile Before and After Intravitreal Bevacizumab Therapy for Neovascular Age-Related Macular Degeneration

Abstract

Purpose: : To monitor serum VEGF165 and lipid profile in patients with wet AMD treated with intravitreal bevacizumab and correlate the changes with visual acuity results.

Methods: : Twenty-four patients received intravitreal injections of bevacizumab for wet AMD. Blood samples for serum VEGF165 were obtained immediately before treatment and repeated after 3 intravitreal injections. Treatments were performed every four weeks. The results were compared with an aged-matched control group composed of patients without other ocular pathology including AMD or diabetes mellitus submitted to cataract surgery (n=22). In 20 patients serum lipid markers were also obtained (total cholesterol, HDL, LDL and triglycerides) in the same time intervals.

Results: : The patients were divided into two groups concerning visual acuity results after treatment. The first group (n=20) included patients who gained vision (ETDRS score). When compared to the control group, the initial VEGF level was greater in this sample (p=0.034). After the treatment the VEGF level decreased significantly (p=0.04) to control level. In the second group (patients who lost or maintained vision; n=4) there was no statistical difference between the initial VEGF levels and the control group and no statistical change in VEGF levels with treatment. Sixteen patients with lipid profile improved vision. In this subgroup there was a statistically significant decrease in HDL (p=0.02) compared with initial values. There was no significant change in the other tested parameters.

Conclusions: : Patients with wet AMD with increased serum VEGF levels improve visual results when treated with intravitreal bevacizumab. The increase in vision accompanied a decrease in serum VEGF levels. High serum VEGF levels may be a predictor of better response to intravitreal bevacizumab. Intravitreal therapy with bevacizumab is associated with decreased HDL serum levels.

Keywords: age-related macular degeneration • growth factors/growth factor receptors • clinical laboratory testing