Abstract
Purpose. To investigate the correlation between aqueous and serum levels of pigment epithelium-derived factor (PEDF) and macular choroidal thickness in high myopia patients, both with and without choroidal neovascularization (CNV). Methods. Serum and aqueous levels of PEDF were measured by enzyme-linked immunosorbent assay in 36 high myopia patients (36 eyes) with no CNV (non-CNV group), 14 high myopia patients (14 eyes) with CNV (CNV group), and 42 nonmyopia patients (42 eyes) (control group). Macular choroidal thickness was measured by enhanced-depth imaging optical coherence tomography. Results. Aqueous levels of PEDF were significantly higher in CNV group compared with non-CNV (P < 0.001) and control (P < 0.001) groups. Macular choroidal thicknesses were significantly decreased in the non-CNV and CNV groups compared with the control (P < 0.001) group. A statistically significant difference (P = 0.012) was found between the CNV and non-CNV groups. There was a positive correlation between aqueous PEDF and macular choroidal thickness in the non-CNV group (P = 0.005), but no correlation with the CNV group. No correlation between serum PEDF and macular choroidal thickness was detected in the three groups. Conclusion. Variations in aqueous PEDF levels coincide with changes in macular choroidal thickness in high myopia patients with no CNV, while no such relationship exists in high myopia patients with CNV.
Highlights
High myopia, which accounts for 27–33% of all myopia, is a major cause of legal blindness in numerous developed countries worldwide [1], with a prevalence of ∼2% in the general population
Aqueous levels of Pigment epithelium-derived factor (PEDF) were significantly decreased in the non-choroidal neovascularization (CNV) group (3.6 ± 1.3 ng/mL) compared with the control group (4.8 ± 1.8 ng/mL) (P = 0.001) and were significantly elevated in the CNV group (17.0 ± 5.8 ng/mL)
We studied the correlation between aqueous PEDF levels and macular choroidal thickness for the non-CNV group and found a significant, positive correlation (R2 = 0.211, P = 0.005) (Figure 3), while no correlation was found for the CNV group (R2 = 0.108, P = 0.214) (Figure 4)
Summary
High myopia, which accounts for 27–33% of all myopia, is a major cause of legal blindness in numerous developed countries worldwide [1], with a prevalence of ∼2% in the general population. Myopia is characterized by excessive and progressive elongation of the globe (axial length, >26.5 mm) [2] and is associated with degenerative changes of the retina, choroid, and sclera at the posterior segment [3]. Myopic chorioretinal atrophy and choroidal neovascularization (CNV) are common causes of visual loss in high myopes. Since prevention of myopia is presently unachievable, it is of great importance to investigate the underlying mechanisms of and morphological changes associated with chorioretinal atrophy and CNV in highly myopic eyes. PEDF is a more potent inhibitor of angiogenesis in the eye than are other endogenous antiangiogenic molecules [5], and has neurotrophic/neuroprotective functions, playing roles in retinal differentiation, survival, and maintenance. Measurable variations in levels of aqueous PEDF in high myopia—with and without CNV—may indirectly reflect the nature and pathogenesis of these two phases of high myopia
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