Effect of intravitreal ranibizumab injections on aqueous humour concentrations of vascular endothelial growth factor and pigment epithelium-derived factor in patients with myopic choroidal neovascularisation

Br J Ophthalmol. 2015 Jul;99(7):1004-8. doi: 10.1136/bjophthalmol-2014-306465. Epub 2015 Mar 13.

Abstract

Aims: To investigate aqueous humour changes in vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) levels in patients with choroidal neovascularisation (CNV) secondary to pathological myopia (mCNV) before and after intravitreal ranibizumab injection (IVR).

Methods: This was a prospective, case-control study investigating aqueous levels of VEGF and PEDF in eyes with mCNV treated with IVR.

Results: Mean VEGF and PEDF levels in the aqueous humour of control patients were 25.7±4.9 pg/mL and 12.6±3.5 ng/mL, respectively. Lower levels of both VEGF (19.5±5.4 pg/mL) and PEDF (4.7±2.2 ng/mL) were found in patients with mCNV before IVR. After IVR, aqueous VEGF levels significantly reduced to 6.5±2.7 pg/mL, while PEDF levels significantly increased to 35.8±11.4 ng/mL. VEGF and PEDF levels significantly correlated with each other, and with best-corrected visual acuity and central retinal thickness.

Conclusions: The VEGF and PEDF levels in aqueous humour were significantly lower in the myopic group than in controls. Moreover, IVR resulted in reduced VEGF and increased PEDF levels in patients with mCNV. In mCNV, neovascularisation is associated with inappropriate VEGF and PEDF expression. A balance between VEGF and PEDF is crucial to prevent CNV development.

Trial registration number: NCT02175940.

Keywords: PEDF; choroidal neovascularization; pathologic myopia; ranibizumab.

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Aqueous Humor / metabolism*
  • Case-Control Studies
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology
  • Choroidal Neovascularization / metabolism
  • Enzyme-Linked Immunosorbent Assay
  • Eye Proteins / metabolism*
  • Female
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Myopia, Degenerative / complications
  • Myopia, Degenerative / drug therapy*
  • Myopia, Degenerative / metabolism
  • Nerve Growth Factors / metabolism*
  • Prospective Studies
  • Protease Inhibitors / metabolism
  • Ranibizumab
  • Serpins / metabolism*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vascular Endothelial Growth Factor A / metabolism*
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Eye Proteins
  • Nerve Growth Factors
  • Protease Inhibitors
  • Serpins
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • pigment epithelium-derived factor
  • Ranibizumab

Associated data

  • ClinicalTrials.gov/NCT02175940