Influence of vitreous factors after vitrectomy for macular edema in patients with central retinal vein occlusion

Abstract

To investigate whether vitreous fluid levels of vascular endothelial growth factor (VEGF), pigment epithelium-derived factor (PEDF), and soluble intercellular adhesion molecule 1 (sICAM-1) influence visual prognosis and macular edema in patients with central retinal vein occlusion (CRVO). A prospective observational study was performed in 31 consecutive CRVO patients (31 eyes) with macular edema who underwent vitrectomy. Best-corrected visual acuity (BCVA), retinal thickness (examined by OCT), and vitreous fluid levels of VEGF, PEDF, and sICAM-1 were determined. Patients were followed for at least 6months after surgery. Both visual acuity and retinal thickness showed significant improvement at 6months postoperatively (P=0.012 and P<0.001, respectively). Vitreous fluid levels of VEGF were significantly higher (P=0.027) in patients who showed less improvement of BCVA after vitrectomy than in those with a better outcome. Conversely, vitreous levels of PEDF were significantly lower (P=0.047) in patients with less improvement of BCVA than in those with a better outcome. Vitreous levels of sICAM-1 were not significantly correlated with BCVA after vitrectomy (P=0.731). Multiple regression analysis demonstrated that vitreous fluid levels of VEGF and PEDF were significant determinants of the improvement of BCVA (P=0.013 and P=0.007, respectively). These results suggest that vitreous fluid levels of VEGF and PEDF might influence visual prognosis after vitrectomy in CRVO patients with macular edema.