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R. Radhakrishnan, S. Balaiya, V. S. Brar, R. K. Murthy, S. Grover, K. V. Chalam; Aqueous VEGF Levels After Intravitreal Ranibizumab for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5042.
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Anti-vascular endothelial growth factor (VEGF) therapy has been used as an adjuvant in the management diabetic macular edema. We explore the effects of intravitreal ranibizumab on aqueous VEGF levels and its effects on central macular thickness (CMT) on optical coherence tomography (OCT).
Retrospective case study of patients receiving intravitreal injections of ranibizumab. Patients had a full ophthalmic exam prior to injection, including slit lamp examination, indirect ophthalmoscopy, fluorescein angiogram, and OCT. Injections were performed at the discretion of the retina specialist. Prior to the intravitreal injection, a paracentesis was made to obtain a 0.1cc of aqueous sample (pre-sample). A Multiplex Bead-based Luminex assay was used to determine the aqueous VEGF levels. Pre-injection and post-injection OCTs were performed on Zeiss Stratus OCT.
Four patients (4 eyes) were injected with intravitreal Ranibizumab. The mean VEGF level prior to injection was 94.04 pg/ml (2.192-159.532) and post injection was 27.02 pg/ml (4.088-34.909). The CMT prior to injection was 340 microns (249-432) and post injection was 289 microns (253-382). The mean duration between injections was 66 days (28-95).
Aqueous VEGF levels are reduced following treatment with intravitreal ranibizumab and corresponded with improvement on OCT. Assessing aqueous VEGF levels may allow physicians to titrate the dosing and frequency of anti-VEGF therapy in the future.
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