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Masahiro Miyake, Yuki Muraoka, Ayako Takahashi, Yuko Iida-Miwa, Tomoaki Murakami, Sotaro Ooto, Rima Ghashut, Kiyoshi Suzuma, Akitaka Tsujikawa, Yuto Iida; Association Between Aqueous VEGF Levels and Clinical Parameters in Ranibizumab Treatment for Eyes with Branch Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4280.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate aqueous vascular endothelial growth factor (VEGF) levels and their association with clinical parameters of eyes with branch retinal vein occlusion (BRVO) that received intravitreal ranibizumab (IVR) injections for macular edema (ME).
This prospective study was approved by the Institutional Review Board, Kyoto University Graduate School of Medicine (Kyoto, Japan), and adhered to the Declaration of Helsinki. Forty-one consecutive eyes (41 patients; mean age, 73.0±10.8 years) with treatment-naïve, acute BRVO accompanying ME were included. All patients received 3 monthly IVR injections. Each patient was examined monthly for 12 months after the initial injection, and an additional IVR injection was administered when ME or serous retinal detachment was evident at the fovea on optical coherence tomography (OCT). Except ranibizumab, these eyes received no other treatment, such as scatter laser photocoagulation, grid laser photocoagulation, steroid treatment, surgical intervention, or other anti-VEGF agents. VEGF levels were measured using an enzyme-linked immunosorbent assay with aqueous humor that was obtained immediately before the initial IVR injection. The total retinal nonperfusion area (NPA) and vascular leakage of the retina, central foveal thickness (CFT), and macular NPA were quantitively measured with ultrawide-field fluorescein angiography, OCT, and OCT angiography, respectively.
The mean aqueous VEGF level before the initial IVR injection was 279.0±162.0 pg/ml, which was significantly associated with the total NPA, dye leakage, CFT, and height of serous retinal detachment at the fovea (r=0.547, P<0.001; r=0.775, P<0.001; r=0.465, P=0.002; r=0.548, P<0.001, respectively). VEGF levels in eyes with broad NPA varied based on the amount of vascular leakage. The aqueous VEGF levels did not significantly associate with initial and final visual acuities (VAs), initial macular NPAs (superficial and deep capillary plexuses), or the number of IVR injections over 12 months (P=0.228, P=0.779, P=0.051, P=0.082, P=0.934, respectively).
Aqueous VEGF levels in eyes with treatment-naïve BRVO were significantly associated with vascular leakage and total NPA that were examined before the initial IVR injection. However, pretreatment VEGF levels were not a prognostic factor for final VA and the number of IVR injections required.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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