Serum and Plasma Vascular Endothelial Growth Factor Concentrations Before and After Intravitreal Injection of Aflibercept or Ranibizumab for Age-Related Macular Degeneration

Abstract

To evaluate serum and plasma vascular endothelial growth factor (VEGF) concentrations in neovascular age-related macular degeneration patients treated bimonthly with an intravitreal injection of aflibercept or ranibizumab. Prospective, interventional case series. This study includes 17 eyes of 17 patients treated with 2 mg aflibercept (the aflibercept group), 15 eyes of 15 patients treated with 0.5 mg ranibizumab (the ranibizumab group), and 12 patients with cataract (the control group). Serum and plasma VEGF concentrations were quantified using the enzyme-linked immunosorbent assay. At baseline, mean serum VEGF concentration (in picograms per milliliter) did not differ significantly among the 3 groups (P = .99). In the aflibercept group, it was 28.3 pg/mL at baseline, decreased to below the detectable limit at 1 week (P < .0001), increased to 11.7 pg/mL at 1 month, which was still significantly less than the baseline level (P < .001), and returned to 23.9 pg/mL (P = .35) at 2 months. In the ranibizumab group, there were no significant differences. At baseline, mean plasma VEGF concentration did not differ significantly among the 3 groups (P = .64). In the aflibercept group, it was 16.2 at baseline, decreased to less than the detectable limit at 1 week (P < .01) and at 1 month (P < .05), and returned to 13.6 pg/mL at 2 months (P = .73). In the ranibizumab group, there were no significant differences. Aflibercept significantly decreased serum and plasma VEGF concentrations 1 month after injection; however, ranibizumab had no significant effect on either serum or plasma VEGF level.