| Objective:To observe the changes of microRNA?miRNA?-126,vascular endothelial growth factor?VEGF?-A expression and related clinical indicators in the plasma of patients with wet age-related macular mutation?wAMD?injected intravitreally.Methods:Forty cases?40 eyes?of wAMD patients admitted to the department of ophthalmology of our hospital from June 2018 to June 2019 were selected as the research group,including 23 females and 17 males.A total of 40 middle-aged and elderly patients who underwent physical examination in the physical examination center of our hospital during the same period were selected as the control group,including 22 females and 18 males.Patients in the study group received a single intravitreal injection of ranibizumab?0.05ml?.Real-time quantitative fluore scence PCR?qPCR?was used to detect the plasma expression levels of miRNA-126 in the control group,the study group before and 1 month after treatment,and the plasma concentration of vascular endothelial growth factor?VEGF?-A was detected by enzyme-linked immunosorbent assay?ELISA?.The standard logarithmic visual acuity chart was used to check the best corrected visual acuity?BCVA?of patients in the study group before treatment and 1 month after treatment in the study group.Optical coherence tomography angiography?OCTA?examines the retinal thickness?CMT?and choroidal neovascularization?CNV?area in the central region of the macula.?1?The expression levels of miRNA-126 and VEGF-A in the plasma of the control group and the study group were compared before treatment.?2?he changes of miRNA-126 expression level,VEGF-A concentration,BCVA,CMT and CNV area in plasma of the study group before treatment and1 month after treatment were compared.?3?Linear regression analysis was used to study the correlation between the expression level of miRNA-126 in plasma and the concentration of VEGF-A and CMT and CNV in the group before and 1month after treatment.Results:1.The expression level of miRNA-126 in the study group before treatment?0.862±0.111?was significantly lower than that in the control group?1.037±0.092?,and the concentration of VEGF-A?329.087±17.576?pg/mL was significantly higher than that in the control group?295.736±14.802?pg/mL,the differences were statistically significant?t=8.010,9.179,P values<0.01?.2.The expression level of miRNA-126?1.468±0.265?in plasma of the study group 1 month after treatment was significantly higher than that before treatment?0.862±0.111?,and the concentration of VEGF-A?315.360±15.444?pg/mL was higher than that before treatment?329.087±17.576?pg/mL was significantly reduced,and the differences were statistically significant?t=19.410,8.048,all P values<0.01?.BCVA?0.448±0.113?was significantly increased compared with before treatment?0.828±0.163?,and the areas of CMT and CNV were?296.530±21.515??m and?0.579±0.176?mm2compared with?311.876±37.245??m and?0.695±0.170?mm2were significantly reduced,and the differences were statistically significant?t=12.667,3.602,4.906,all P values<0.01?.3.The expression levels of miRNA-126 in plasma of the study group before treatment and 1 month after treatment were significantly negatively correlated with VEGF-A concentration,CMT,and CNV?r before treatment=-0.706,-0.723,-0.552,one after treatment Month=-0.783,-0.709,-0.620,P values are all<0.01?.The linear regression equations fitted to VEGF-A,CMT,CNV and miRNA-126 before treatment were:YVEGF-=-112XmiRNA-126+426,YCMT=-243XmiRNA-126+522,YCNV=-0.84XmiRNA-126+1.42.The fitted linear regression equations after treatment were:YVEGF-A=-45.64XmiRNA-126+382,YCMT=-57.53XmiRNA-126+381,YCNV=-0.41XmiRNA-126+1.18.Conclusion:1.Intravitreal injection of ranibizumab can reduce the concentration of VEGF-A,thereby reducing the thickness of the retina and the area of choroidal neovascularization in the central area of the macula,thereby improving the patient's vision.2.Intravitreal injection of ranibizumab may also increase miRNA-126 gene expression,thereby reducing the concentration of VEGF-A,and thus slowing the occurrence and development of wAMD. |
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