Abstract
PurposeTo evaluate changes in the concentrations of placental growth factor (PlGF) and vascular endothelial growth factor-A (VEGF-A) in aqueous humor of patients with neovascular glaucoma (NVG) before and after an intravitreal injection of ranibizumab (IVR) and to determine the underlying correlation between the levels.MethodsThe prospective interventional comparative study involved 20 eyes of 20 patients with surgery-required advanced NVG and 20 control subjects from January 2013 to November 2013. The NVG eyes received the IVR treatment before glaucoma surgery. Aqueous humor was collected at the time of the IVR injection (pre- IVR) and at the time of antiglaucomatous surgery (post-IVR). Aqueous humor was also collected at the time of cataract surgery in normal control. Aqueous humor and plasma VEGF-A and PlGF levels were measured with an enzyme-linked immunosorbent assay methods, respectively.ResultsThe mean aqueous humor PlGF and VEGF-A concentrations in the pre-IVR eyes were significantly higher than in those of the control subjects (p<0.001), whereas the plasma levels showed no significant difference. There was a statistically significant correlation between the aqueous humor PlGF and the VEGF-A concentration (r = 0.612, p = 0.003). The mean aqueous humor PlGF in the post-IVR eyes dramatically decreased from 1078.36 ± 755.83 to 177.64 ± 151.73 pg/mL (p<0.001). The VEGF-A level showed a similar trend from 3697.64 ± 2104.47 pg/mL to 183.54 ± 130.35 pg/mL (p<0.001).ConclusionsAqueous humor concentrations of VEGF-A and PlGF were significantly elevated in the eyes with NVG, and there was a positive correlation between the levels. After an IVR treatment, VEGF-A and PlGF were significantly decreased in NVG eyes.
Highlights
Neovascular glaucoma (NVG) is an intractable, challenging disease of the eye that can result in permanent blindness
Aqueous humor concentrations of vascular endothelial growth factorA (VEGF-A) and placental growth factor (PlGF) were significantly elevated in the eyes with NVG, and there was a positive correlation between the levels
After an IVR treatment, VEGF-A and PlGF were significantly decreased in NVG eyes
Summary
Neovascular glaucoma (NVG) is an intractable, challenging disease of the eye that can result in permanent blindness. The main characteristics include iris and angle neovascularization, which almost invariably appear[1]. Angiogenesis is a key aspect of ocular neovascularization and NVG. Studies have provided substantial evidence that vascular endothelial growth factorA (VEGF-A) is a major mediator of angiogenesis and vascular leakage in ocular neovascularization[2,3,4]. VEGF-A is a prototype member of the VEGF family, which includes placental growth factor (PlGF), VEGF-B, VEGF-C, VEGF-D, and VEGF-E[5]. The importance of VEGF-A in hypoxia-induced neovascularization is well known, but the role of the other recognized members of the VEGF family of peptides in ocular neovascularization and their interaction with VEGF-A is less well-defined
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