Effection Of VEGF Family In Eye Of Proliferative Diabetic Retinopathy And Effection Of Vitrectomy After Intravitreal Ranibizumab Injection

Objective:To observe the concentration of the Vascular endothelial growth factor(VEGF)-A,VEGF-B and placental growth factor(PIGF)in aqueous humor,vitreous and neovascular membrane of proliferative diabetic retinopathy(PDR)and the effect of vitrectomy after intravitreal ranibizumab injection(IVR).Methods:A total of 60 PDR patients(60 eyes)were enrolled in this study.The patients were randomly divided into pars plana vitrectomy(PPV)group and IVR combined with PPV group,30 eyes in each group.Samples of aqueous humor,vitreous and neovascular membrane vitrectomy were collected in the vitrectomy group group.Samples of aqueous humor were collected before and 7 days after IVR in the IVR combined with vitrectomy group.Samples of vitreous and neovascular membrane were collected in the IVR combined with vitrectomy group.The concentrations of VEGF-A,VEGF-B and PIGF in the aqueous humor and vitreous were easured by enzyme linked immunosorbent assay(ELISA).The expression of VEGF-A,VEGF-B and PIGF in the proliferative membrane measured by immunohistochemistry method.The number of blood vessels in the proliferative membrane was observed by haematoxylin and eosin(HE)stain.TO observe the surgical time,severity of intraoperative bleeding between the two groups.Results:The VEGF-A concentration in the aqueous humor were reduced significantly after IVR in the IVR combined with vitrectomy group(P<0.05).There were no significant difference between before and after IVR in the aqueous humor VEGF-B and PIGF concentration in the IVR combined with vitrectomy group(P>0.05).The concentration of VEGF-A in the aqueous humor,vitreous and proliferative membrane in the IVR combined with vitrectomy group(after IVR)were significantly lower than the vitrectomy group(P<0.05).The concentration of VEGF-B and PIGF in the aqueous humor,vitreous and proliferative membrane had no significant between the two groups(P>0.05).The number of blood vessels,the surgical time,severity of intraoperative bleeding in the proliferative membrane in the IVR combined with vitrectomy group were obviously lower than the vitrectomy group(P<0.05).Conclusion:Ranibizumab significantly decreased VEGF-A concentration,the number of blood vessels in the proliferative membrane,the surgical time,severity of intraoperative bleeding,which improved surgical safety and reduced postoperative complications.Ranibizumab decreased VEGF-B and PIGF,but had no effect.