Antiangiogenic shift in vitreous after vitrectomy in patients with proliferative diabetic retinopathy.
Antiangiogenic shift in vitreous after vitrectomy in patients with proliferative diabetic retinopathy.
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DOI：
10.1167/iovs.12-9671
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发表时间：
2012-10
影响因子：
4.4
通讯作者：
S. Yoshida;Takahito Nakama;K. Ishikawa;Mitsuru Arima;Takashi Tachibana;S. Nakao;Y. Sassa;Miho Yasuda;H. Enaida;Y. Oshima;T. Kono;T. Ishibashi
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文献类型：
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作者：
S. Yoshida;Takahito Nakama;K. Ishikawa;Mitsuru Arima;Takashi Tachibana;S. Nakao;Y. Sassa;Miho Yasuda;H. Enaida;Y. Oshima;T. Kono;T. Ishibashi
目的：研究增殖性糖尿病视网膜病变（PDR）患者玻璃体切除术后玻璃体中VEGF、促红细胞生成素和内皮抑素的浓度是否发生改变。方法采用夹心ELISA法检测33例PDR患者玻璃体切除术前（未植入人工晶状体）采集的38只眼玻璃体样本中VEGF、促红细胞生成素和内皮抑素的水平，并在首次玻璃体切除术后3.1 ~ 25.7个月（平均6.7个月）进行人工晶状体植入术。结果PDR患者玻璃体切除术前玻璃体标本中VEGF （964.5 pg/mL）和促红细胞生成素（1359.5 pg/mL）水平显著高于对照组（分别为0.68和70.7 pg/mL, P < 0.01）。人工晶状体植入术时PDR眼标本中VEGF （292.5 pg/mL）和促红细胞生成素（557.9 pg/mL）水平显著低于玻璃体切除术前（P < 0.01）。相比之下，玻璃体切除术后内皮抑素水平的变化不显著。PDR患者玻璃体液中VEGF和促红细胞生成素水平与初始玻璃体切除术与人工晶状体植入术的时间间隔呈负相关。结论玻璃体切除术成功后，PDR患者玻璃体内VEGF和促红细胞生成素浓度显著降低，内皮抑素无显著变化，提示玻璃体内抗血管生成平衡发生改变。
PURPOSE We determined whether the concentrations of VEGF, erythropoietin, and endostatin in the vitreous are altered after vitrectomy in patient with proliferative diabetic retinopathy (PDR). METHODS We measured the levels of VEGF, erythropoietin, and endostatin by sandwich ELISA in vitreous samples collected from 38 eyes of 33 patients with PDR before pars plana vitrectomy (without IOL implantation) and the same 38 eyes during IOL implantation 3.1 to 25.7 (mean 6.7) months after the initial vitrectomy. RESULTS The mean vitreous levels of VEGF (964.5 pg/mL) and erythropoietin (1359.5 pg/mL) in the samples collected before vitrectomy were significantly higher in patients with PDR than in the control patients (0.68 and 70.7 pg/mL, respectively; P < 0.01). The levels of VEGF (292.5 pg/mL) and erythropoietin (557.9 pg/mL) in the samples from eyes with PDR collected at the time of IOL implantation were significantly lower than those collected before vitrectomy (P < 0.01). In contrast, the changes in the level of endostatin were not significant after vitrectomy. The VEGF and erythropoietin levels in the vitreous fluid from patients with PDR were correlated inversely with the interval between the initial vitrectomy and the time of the IOL implantation. CONCLUSIONS The significant decrease in the intravitreal concentration of VEGF and erythropoietin, and an absence of a significant change in the endostatin indicated a shift in the antiangiogenic balance in the vitreous of patients with PDR after successful vitrectomy.