| Objective:To evaluate changes in the concentrations of vascular endothelial growth factor(VEGF)and placenta growth factor(Pl GF)in aqueous humor and vitreous of patient with proliferative diabetic retinopathy(PDR),before and after intravitreal injectionof Conbercept,to determine the underlying correlation between the levels,and toprovide a theoretical basis for the treatment of PDR.Methods:25 patients were enrolled in this study from December 2015 to December 2016 in our hospital.16 patients with PDR were divided into A group(8 patients with 9 eyes)and Bgroup(8 patients with 9 eyes).Group A was treated with IVC combined with vitrectomy.The aqueous humor was collected before IVC injection.After 7 days of IVC injection,aqueous humor and vitreous humor were collected before vitrectomy.Group B was treated withvitrectomy,aqueous humor and vitreous were collected before vitrectomy.The non-diabetic rhegmatogenous retinal detachment required vitrectomy in patients with 9 cases were collected as the control group,aqueous humor and vitreous were collected before vitrectomy.The levels of VEGF and Pl GF in aqueous humor and vitreous humor were measured by enzyme-linked immunosorbent assay(ELISA).Results: 1?The average concentration of VEGF in the aqueous humor of the group A was 269.255 ± 118.1pg /ml and the Pl GF was 355.464 ± 204.875 pg / ml.After IVC injection the concentration of VEGF was 128.712 ± 60.692 pg / ml,Pl GF was 219.622 ± 151.487 pg / ml.The average concentration of VEGF and Pl GF in the aqueous humor of group B was 301.0291 ± 173.582 pg / ml and 478.733 ± 273.873 pg / ml.The average concentration of VEGF and Pl GF in the control group was 11.751 ± 5.53 pg / mland 12.363 ± 7.279 pg / ml.The levels of VEGF and Pl GF in the aqueous humor of the group Aand B were significantly higher than those in the control group(Z =-3.578,P <0.05).The levels of VEGF and Pl GF in the aqueous humor were significantly different in pre-IVCand post-IVC(Z =-2.666,P <0.05).There was no significant difference in the concentration of VEGFand Pl GF between the group A pre-IVC and the group B(Z =-0.221,-0.927,P> 0.05).2?The average concentration of VEGF and Pl GF in the vitreous of the group B was 911.804 ± 330.925 pg / ml and 763.774 ± 373.526 pg / ml,and the control group was 41.964 ± 10.115 pg / ml,and 40.742 ± 20.27 pg / ml.The concentration of VEGF and Pl GF in the group B was significantly different from that in the control group(Z =-3.584,-3.578,P <0.05).3?There was a positive correlation between VEGF and Pl GF concentration in aqueous humor of group A pre-IVC(r= 0.683,P <0.05),post-IVC(r=0.800,P <0.05)and group B(r = 0.07,P <0.05).There was no significant correlation between the concentration in the aqueous humor of VEGF and Pl GF in the control group(r = 0.075,P> 0.05).4?There was a positive correlation between VEGF and Pl GF concentration in the vitreous of group B(r=0.867,P <0.05).There was no significant correlation between VEGF and Pl GF concentration in the vitreous of group A post-IVR(r= 0.567,P> 0.05)and control group(r=0.375,P> 0.05).5?There was a positive correlation between the concentration of VEGF in the aqueous humor and vitreous in group Apre-IVC(r=0.800,P <0.05)and group B(r=0.717,P <0.05).There was a positive correlation between the concentration of Pl GF in the aqueous humor and vitreous ingroup A pre-IVC(r=0.833,P <0.05)and group B(r=0.800,P <0.05).There was no significant correlation between the concentration of VEGF(r=0.519,P> 0.05)and Pl GF(r=0.435,P> 0.05)in the aqueous humor and vitreous incontrol group.6?The mean log MAR BCVA at 3 months after operation in group Awas 0.743 ± 0.487,in group B was 1.147 ± 0.95,in control group was 0.48 ± 0.199.There was significant difference between the three groups(t =9.463,P <0.05),but there was no significant difference between the group A and group B(t=-1.546,P> 0.05).The mean CMT of group A andgroup Bwas 267.778 ± 120.695?m(range: 152 ~ 548?m)and 410.889 ± 213.542?m(range: 179 ~ 769?m). There was no significant difference between the group A and group Bat CMT(Z=-1.546,P>0.05).Conclusions: 1?The highlevels of VEGF and Pl GF in aqueous and vitreous humor of patients with PDR may be closely related to the occurrence and development of intraocular neovascularization.2?The levels of VEGF and Pl GF in aqueous humor and vitreous decreased after IVC injection,which indicated that Conbercept had a good inhibitory effect on VEGF and Pl GF.3?The concentration of Pl GFin aqueous humor and vitreous in PDR patients was significantly correlated with the concentration of VEGF,indicating that there may be a mutual regulation mechanism between the two factors,and the production of cytokines was mainly in the retina.4?PDR patients by IVC injection combined with 23 G vitrectomy,can improve visual acuity,but visual acuity improved with whether the treatment of IVC no significant relationship.There was a positive correlation between visual acuity and CMT. |
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