Vitreous Mediators after Intravitreal Bevacizumab or Triamcinolone Acetonide in Eyes with Proliferative Diabetic Retinopathy

Noboru Arimura, Hiroki Otsuka, Keita Yamakiri, Yasushi Sonoda, Shintaro Nakao, Yoshihiro Noda, Teruto Hashiguchi, Ikuro Maruyama, Taiji Sakamoto

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Abstract

Purpose: To evaluate vitreous vascular endothelial growth factor (VEGF), stromal cell-derived factor 1α (SDF-1α), interleukins (ILs), and tumor necrosis factor-α (TNF-α) after intravitreal bevacizumab or triamcinolone acetonide (TA) in eyes with proliferative diabetic retinopathy (PDR). Design: Interventional, consecutive, retrospective, comparative study with a historical control. Participants: Forty-seven eyes of 47 patients affected by active PDR were investigated. Bevacizumab (1.25 mg; 19 eyes; bevacizumab group) or TA (4 mg; 10 eyes; TA group) was injected into the vitreous cavity as preoperative adjunctive therapy 7 days before vitrectomy. Eighteen eyes without injection served as controls (control group). Methods: The vitreous samples were obtained at vitrectomy and were analyzed for concentrations of total protein, VEGF, SDF-1α, IL-1β, IL-6, IL-8, IL-10, IL-12p70, and TNF-α. Main Outcome Measures: Vitreous concentrations of VEGF, SDF-1α, ILs, and TNF-α were compared among bevacizumab, TA, and control groups. Results: Vitreous concentrations of VEGF and SDF-1α were lower in bevacizumab and TA groups compared with the control group. The median VEGF level was 0 pg/ml (range, 0-79.2 pg/ml) in the bevacizumab group, 343.5 pg/ml (range, 0-1683.3 pg/ml) in the TA group, and 1202.5 pg/ml (range, 76-4213.9 pg/ml) in the control group. The median SDF-1α level was 149.2 pg/ml (range, 0-519.4 pg/ml) in the bevacizumab group, 87.5 pg/ml (range, 0-252.5 pg/ml) in the TA group, and 245.7 pg/ml (range, 0-856.8 pg/ml) in the control group. The differences in both vitreous VEGF and SDF-1α concentrations among 3 groups were statistically significant (P<0.001 and P = 0.010, respectively). The eyes with intravitreal bevacizumab demonstrated the lowest vitreous level of VEGF, and the level was statistically significant compared with the eyes with intravitreal TA and control eyes (P<0.001 and P<0.001, respectively). The control eyes had the highest vitreous level of SDF-1α, and the level was statistically significant compared with the eyes with intravitreal bevacizumab and TA (P = 0.015 and P = 0.009, respectively). There was no significant difference regarding ILs and TNF-α. Conclusions: Intravitreal injection of bevacizumab potentially diminishes not only VEGF but also SDF-1α. These findings suggest that intravitreal bevacizumab may influence intraocular mediators beyond VEGF. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Original languageEnglish
Pages (from-to)921-926
Number of pages6
JournalOphthalmology
Volume116
Issue number5
DOIs
Publication statusPublished - May 2009

All Science Journal Classification (ASJC) codes

  • Ophthalmology

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    Arimura, N., Otsuka, H., Yamakiri, K., Sonoda, Y., Nakao, S., Noda, Y., Hashiguchi, T., Maruyama, I., & Sakamoto, T. (2009). Vitreous Mediators after Intravitreal Bevacizumab or Triamcinolone Acetonide in Eyes with Proliferative Diabetic Retinopathy. Ophthalmology, 116(5), 921-926. https://doi.org/10.1016/j.ophtha.2008.12.024