Correlations Of The Changes Of Aqueous Humor VEGF In Patients With Proliferative Diabetic Retinopathy Or Diabetic Macular Edema After Intravitreal Anti-VEGF Agents Injections And The Prognosis Of The Disease

Purpose: To evaluate the correlations of the changes of concentrations of VEGF in aqueous humor of patients with proliferative diabetic retinopathy(PDR)or diabetic macular edema(DME)after intravitreal anti-VEGF treatment and the prognosis of the disease.Method: 12 patients(12 eyes)with DME and 10 patients(13 eyes)with PDR who had at least 3 consecutive intravitreal injections of anti-VEGF agents were included.Patients diagnosed as age-related cataract but with no retinal diseases were included as control.The patients in the experimental group were treated with 0.05 ml ranibizumab or aflibercept monthly for 3 times,and then injected as needed according to the change of the condition during the follow-up.The VEGF levels in aqueous humor were measured by ELISA test.The correlation between VEGF levels and baseline characteristics,central subfield thickness(CST)and best corrected visual acuity(BCVA)was compared.Results: The VEGF levels in aqueous humor of DME patients were correlated with the best corrected visual acuity BCVA(logMAR),r = 0.494(P = 0).In all DR patients,BCVA(logMAR)was not correlated with VEGF level,r = 0.227(P = 0.02),nor it correlated with the central subfield thickness(CST),r = 0.216(P = 0.027).The BCVA(LogMAR)after the first and second injection of PDR patients were not only correlated with the baseline value of BCVA,but also correlated with the baseline level of glycated hemoglobin,the correlation coefficients were 0.756(P=0.003)and 0.581(P=0.037),respectively.VEGF levels in 4 patients(33.3%)with DME and 5 patients(41.7%)with PDR gradually entered the plateau stage after 3 months of treatment.Some DME patients had rebound elevation of VEGF,along with macular edema recurrence and visual acuity decline,which was not seen in PDR patients.Conclusion: There was a moderate negative correlation between the VEGF levels of aqueous humor and BCVA in DME patients.There was no significant correlation among VEGF levels,CST and BCAV in all DR patients.VEGF in aqueous humor had plateau stage and rebound phenomenon.Higher baseline glycated hemoglobin levels may affect the prognosis of visual acuity in PDR patients.