Intravitreal injection of ranibizumab for treatment of age-related macular degeneration: effects on serum VEGF concentration.

AIMS: To evaluate potential adverse ranibizumab-related systemic events through analysis of variations in serum levels of vascular endothelial growth factor (VEGF) in neovascular age-related macular degeneration (AMD) patients before and after a single intravitreal injection of ranibizumab. METHODS: Thirty-nine patients with neovascular AMD and 39 healthy control subjects were enrolled in the study. Patients received a single intravitreal injection of ranibizumab (0.5 mg) in one eye. Venous blood was collected and placed in coagulation-promoting tubes 1 day before and on post-injection days 1, 3, 7 and 30. Serum concentrations of VEGF were measured by ELISA at each time point. RESULTS: VEGF concentrations were 323.64 pg/ml in AMD patients and 392.94 pg/ml in control subjects before injection (p > 0.05). VEGF significantly decreased to 304.65 pg/ml 1 day later (p < 0.05) in AMD patients, then increased to 310.77 (p > 0.05), 317.89 (p > 0.05) and 311.79 pg/ml (p > 0.05) on post-injection days 3, 7 and 30, respectively. CONCLUSION: No significant changes in serum levels of VEGF were found from 3 to 30 days following a single intravitreal ranibizumab injection. Although certain influences existed 24-h post-injection, effect(s) of a single intravitreal ranibizumab injection on the homeostasis of the cardiovascular system during such a brief period is unknown.