Vitreous and serum VEGF levels after intravitreal injection of bevacizumab, ranibizumab and triamcinolone acetonide in patients with proliferative diabetic retinopathy

Abstract

PurposeTo compare ocular and systemic vascular endothelial growth factor (VEGF) antagonizing effect of bevacizumab (IVB), ranibizumab (IVR) and triamcinolone acetonide (IVT) following intravitreal injection in eyes with proliferative diabetic retinopathy (PDR).MethodsThirty‐one eyes of 28 patients with diabetic retinopathy and 21 eyes of 21 non‐diabetic patients having various vitreoretinal diseases underwent vitrectomy. Eyes with PDR were injected with IVB (n = 7), IVR (n = 10) or IVT (n = 6) 3 days prior to vitrectomy. The non PDR eyes (n = 8) was not injected. Vitreous and serum samples were obtained during vitrectomy. Serum and vitreous VEGF levels were analyzed using ELISA.ResultsMean (±SD) vitreous VEGF level in diabetic eyes was higher than that of non‐diabetics (1,275.76 ± 3,441.63 pg/ml vs. 82.66 ± 100.71 pg/ml, p < 0.001) while serum VEGF level did not differ (630.17 ± 981.72 pg/ml vs. 506.51 ± 825.64 pg/ml, p = 0.89). In diabetic eyes, VEGF levels in serum and vitreous was similar (p > 0.05) while in non‐diabetics, serum VEGF level was higher than vitreous VEGF level (p < 0.001). In non‐diabetics, there was lower vitreous VEGF levels than that of IVB, IVR, IVT injected eyes with PDR or non‐injected eyes with non‐PDR (p = 0.002, p < 0.001, p = 0.003 and p = 0.002, respectively). There was no difference among serum VEGF levels within PDR subgroups (p > 0.05). IVT suppressed vitreous VEGF level more than IVR did (298.36 ± 442.14 pg/ml vs. 1,525.01 ± 2,605.95 pg/ml, p = 0.03), however after adjusting total protein level, no significance was remained (p = 0.193).ConclusionsVitreous VEGF level was similarly affected 3 days after injection of IVB, IVR and IVT.AcknowledgementThis project was supported by Marmara University, Scientific Research Projects Committee.