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Jing Feng, Yanrong Jiang; Preoperative Timing of Intravitreal Bevacizumab Injection for Proliferative Diabetic Retinopathy Patients. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1897.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the changes of aqueous concentrations of inflammatory cytokines and fibrosis factors, and to detect the expression of VEGF and proliferating cells on fibrovascular membranes (FVMs) of patients with proliferative diabetic retinopathy (PDR) after intravitreal injection of bevacizumab (IVB).
Forty-two eyes of 42 patients with PDR, including 28 eyes that received an IVB (1.25 mg) 2 days, 5 days, and 14days before pars plana vitrectomy (PPV), and 14 eyes without IVB, and 10 eyes of 10 patients with nondiabetic ocular diseases were enrolled. Aqueous concentrations of inflammatory cytokines and fibrosis factors were analyzed by multiplex bead assay. The expressions of VEGF and proliferating cells in the excised epiretinal membranes were examined by fluorescence immunostaining.
PDR eyes without IVB had the highest vitreous VEGF levels; and the level was statistically significant compared with that of PDR eyes with 2 days injection before surgery, that of PDR eyes with 5 days injection before surgery, and that of nondiabetic eyes (P = .011, P = .012, P < .001, respectively). In the epiretinal fibrovascular membranes of 21 days after IVB group, fibroblastic cells and CTGF progressively more expressed.
IVB may lead to a decrease in the intraocular concentrations of VEGF on 2-5 days, and may induce the formation of proliferation on 21 days, which suggest that the PPV timing after preoperative IVB for PDR patients should within 1 week.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
All the aqueous humor concentrations (pg/ml) of cytokines (PDR: the blank control group). The PDR eyes without IVB had the highest aqueous level of VEGF, and the level was statistically significant compared with that of PDR eyes with 2 days injection before surgery, that of PDR eyes with 5 days injection before surgery, and that of nondiabetic eyes (P = .011, P = .012, P < .001, respectively). However, no significant differences in the concentrations of aqueous VEGF could be found between the PDR eyes without IVB group and that of PDR eyes with 14 days injection before surgery (P = .064).
Immunostaining for CD501 (green), Vimentin (green), Iba1 (green) and DAPI (blue) in epiretinal FVMs from eyes in the PDR without IVB group, in the PDR with IVB 7 days before PPV group, and PDR with IVB 21 days before PPV group. The number of Vimentin cells was significantly increased after IVB in 21 days (P=.018). Bar: 50um.
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