Changes of aqueous vascular endothelial growth factor and pigment epithelium-derived factor following intravitreal bevacizumab for macular oedema secondary to branch retinal vein occlusion.

BACKGROUND: To investigate sequential changes of aqueous vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) in macular oedema secondary to branch retinal vein occlusion (BRVO) following intravitreal injection of bevacizumab (IVB). METHODS: We recruited 10 healthy controls and 40 patients with BRVO. Aqueous levels of VEGF and PEDF were measured by ELISA at the time of IVB and 6 weeks later. Non-response to IVB was defined as showing persistent macular oedema based on reduction of central macular thickness by less than 20% from baseline measurements by optical coherence tomography and vision improvement by <0.3 log MAR at 6 weeks after IVB. Fluorescein angiography was performed after resolution of foveal haemorrhage. We compared aqueous levels of VEGF and PEDF between responders and non-responders. RESULTS: The aqueous levels of VEGF and PEDF were significantly higher in 16 non-responders than in 24 responders at baseline measurements (491 +/- 231 pg/mL vs. 250 +/- 112 pg/mL, P < 0.001; 32 +/- 4 ng/mL vs. 25 +/- 5 ng/mL, P < 0.001, respectively). Six weeks after IVB, the aqueous levels of VEGF and PEDF were still higher in non-responders than in responders (388 +/- 141 pg/mL vs. 104 +/- 40 pg/mL, P < 0.001; 30 +/- 8 ng/mL vs. 18 +/- 5 ng/mL, P < 0.001, respectively). Fluorescein angiography revealed that non-responders showed higher frequencies of macular ischaemia and ischaemic BRVO. CONCLUSIONS: Our results indicate that aqueous VEGF levels are associated with persistent macular oedema secondary to ischaemic BRVO following IVB.

Changes of aqueous vascular endothelial growth factor and interleukin-6 after intravitreal triamcinolone for branch retinal vein occlusion.

BACKGROUND: To investigate sequential changes of aqueous vascular endothelial growth factor (VEGF) and interleukin (IL)-6 in macular oedema secondary to branch retinal vein occlusion after single intravitreal injection of triamcinolone acetonide (IVTA). METHODS: We recruited 10 healthy controls and 30 patients at Chonnam National University Hospital, Gwangju, Korea. Aqueous and plasma levels of VEGF and IL-6 were measured by enzyme-linked immunosorbent assay at the time of IVTA and 3 months later. Non-response to IVTA was defined as showing persistent macular oedema based on a reduction of central macular thickness by less than 20% from baseline measurements by optical coherence tomography and vision improvement by less than 0.3 logMAR. Fluorescein angiography was performed 6 months after IVTA. We compared aqueous levels of VEGF and IL-6 between responders and non-responders. RESULTS: The aqueous levels of VEGF and IL-6 were significantly higher in 12 non-responders than in 18 responders at baseline measurements (511 +/- 245 pg/mL vs. 230 +/- 108 pg/mL, P < 0.001; 38 +/- 31 pg/mL vs. 16 +/- 13 pg/mL, P < 0.001, respectively). Aqueous levels of VEGF were still higher in non-responders (312 +/- 64 pg/mL) 3 months after IVTA, and aqueous levels of VEGF in responders returned to normal (86 +/- 21 pg/mL, P < 0.001). Aqueous levels of IL-6 normalized in all patients 3 months after IVTA. Fluorescein angiography revealed that non-responders showed higher frequencies of macular ischaemia and ischaemic branch retinal vein occlusion. CONCLUSIONS: IL-6-independent VEGF secretion may contribute to persistent macular oedema associated with ischaemic BRVO after IVTA.