Abstract
Abstract: :
Purpose: Rubeotic glaucoma is a frequent complication after vitrectomy for proliferative diabetic retinopathy (PDR). To assess the level of vascular endothelial growth factor (VEGF) in the vitreous fluid obtained at vitreous surgery and at postoperative fluid air exchange. Methods: Using ELISA, we measured VEGF level in vitreous samples from 17 eyes of 15 patients with PDR during vitrectomy and fluid samples obtained from fluid air exchange at 5–36 postoperative days. Six of the 17 eyes developed rubeosis after vitrectomy. VEGF level was also examined in the vitreous fluid obtained from 8 eyes with macular hole at vitrectomy and postoperative fluid air exchange. We measured the plasma VEGF level in all patients. Results: VEGF level in 17 eyes with PDR was1162.3±173.2 pg/ml in the vitreous sample and 1180.4±182.8 pg/ml in the postoperative fluid sample. The plasma VEGF level was 116.1±10.2 pg/ml in PDR. In 8 eyes with macular hole, VEGF level was 96.9±11.5 pg/ml in the vitreous sample and 73.9±12.3 pg/ml in the fluid sample. The plasma VEGF level was 118.5±15.2pg/ml. VEGF level was much higher in PDR than that in macular hole in the vitreous samples (p<0.00005) as well as in the fluid samples (p<0.0001). The VEGF level in the vitreous samples were significantly related to those in the postoperative fluid samples (r=0.790, p<0.0005). Conclusions: High VEGF level was maintained in the vitreous cavity after vitrectomy for PDR. The VEGF level in PDR was 10 times higher than that of the plasma. The results suggested the persistent secretion of VEGF into the vitreous cavity even after vitrectomy in PDR.
Keywords: diabetic retinopathy • vitreous • neovascularization