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M. Funk, K. Kriechbaum, F. Prager, M. Georgopoulos, G. Zlabinger, U. Schmidt-Erfurth; Aqueous Humor Concentrations of Growth Factors and Cytokines in Retinal Vein Occlusion and the Effect of Therapy With Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4571.
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To identify the impact of antiangiogenic therapy on growth factors and inflammatory cytokines in eyes with branch (BRVO) and central retinal vein occlusion (CRVO).
In a prospective clinical trial, 13 eyes of patients with BRVO and CRVO were included. Bevacizumab was administered intravitreously at baseline, month 1 and 2. Re-treatments were given at monthly visits if OCT showed intra- or subretinal fluid, or at vision loss of at least 5 ETDRS letters. Aqueous humor samples were taken each time intravitreal injections were performed. Follow-up was 15 months. Samples from cataract patients served as control.Luminex multiplex assays were used for measurement of 28 growth factors and cytokines.
Significant differences between patients with BRVO or CRVO and control patients were found in the concentration of IL-1b, IL-5, and Eotaxin. Concentrations of IL-1a, IL-10, IL-15, IL-6, IP-10, MCP-1, PDGF-AA, and VEGF varied between CRVO and control patients.Under anti-VEGF therapy, VEGF levels were significantly reduced. Mean values for BRVO were 125.9pg/ml at baseline, 0.01pg/ml at month 1 (p=0.02), 0.57 pg/ml at month 2 (p=0.01), and 0.68pg/ml at month 3 (p=0.02); for CRVO 904.65pg/ml at baseline, 75.17pg/ml at month 1 (p=0.04), 143.81pg/ml at month 2 (p=0.04), and 129.25pg/ml at month 3 (p=0.07).When criteria for re-treatment were met, VEGF levels were high again (e.g. 53.78 pg/ml in patients with BRVO at month 6; p=0.6). Changes of VEGF levels correlated with visual acuity and central retinal thickness (p<0.001).Other significantly reduced cytokines under therapy were IL-1a, IL-1b, IL-12p40, RANTES, and IP-10 in patients with BRVO, and PDGF-AA, IL-6, IP-10, and MCP-1 in patients with CRVO.
Intravitreal injections of Bevacizumab resulted in a substantial decrease of VEGF levels. This effect was measurable over a time period of four weeks after injection. VEGF levels remained low under consecutive monthly re-treatment and increased following discontinuation of therapy with recurrent edema.
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