Levels Of Plasma VEGF Before And After Intravitreal Injection Of Anti-VEGF Agents

Objective: To assess the change of plasma vascular endothelial growth factor(VEGF)levels in patients after one intravitreal injection of anti-VEGF agent.Methods: Prospective cohort study of 54 patients with CNV,DR,RVO,who were anti-VEGF na?ve or had not received anti-VEGF therapy for at least 6 months.Patients received intravitreal injection of Ranibizumab 0.5mg/0.05 ml or Aflibercept 2mg/0.05 ml.Plasma free VEGF levels before,1 day and 30 days after the injection were detected.Results: The average baseline plasma free VEGF level was 39.27±14.52 pg/ml.The plasma VEGF level decreased to 33.25±13.18 pg/ml at the 1st day after intravitreous injection(P <0.05).11 patients were lost to follow up.The plasma VEGF level at one month was similar to the baseline level(38.74±15.66 vs 38.98±18.22,P >0.05).In the ranibizumab group,the plasma VEGF levels did not decrease significantly at any time point(38.02±15.02 vs 37.27±15.77,P >0.05)(34.70±13.50 vs 32.23±13.41,P >0.05).In the Aflibercept group,the plasma VEGF levels declined in the 1st day after intravitreal injection 40.52±14.16 vs 29.24±8.46,P <0.05),and went back to the baseline levels within a month(40.51±15.62 vs 43.38±19.94,P >0.05).Conclusion: Intravitreal injection of anti-VEGF agents can reduce plasma VEGF level over 1 day,however,the decrease goes back to the baseline level within a month.Ranibizumab and Aflibercept showed different influences on the plasma VEGF levels in this small corhort.