Abstract

DO.01.01

Intraocular concentrations of growth factors and cytokines in retinal vascular disease and the effect of anti-VEGF therapy

Funk M.¹, Georgopoulos M.¹, Kriechbaum K.¹, Prager F.¹, Schmidinger G.¹, Sacu S.¹, Zlabinger G.², Schmidt-Erfurth U.^1
1Universitätsklinik für Augenheilkunde und Optometrie, Medizinische Universität Wien, Österreich; ²Institut für Immunologie, Medizinische Universität Wien, Österreich

Objective: Intravitreal anti-VEGF therapy has shown excellent effects in the treatment of neovascular retinal diseases like choroidal neovascularisation (CNV), diabtic maculopathy (DMP) and retinal vein occlusion (RVO). To investigate the underlying pathophysiologic mechanisms of anti-VEGF treatment and the impact of VEGF inhibition on associated growth factors and cytokines, we analyzed the concentration of VEGF and cytokines of patients with retinal vascular diseases before and during anti-VEGF therapy (Ranibizumab, Bevacizumab).
Methods: In a prospective clinical trial patients with CNV (n=45), DMP (n=15), RVO (n=13), and control patients (n=45) were included. Aqueous humour samples were taken before treatment and each time intravitreal injections were performed. Follow-up was up to 15 months. Luminex xMAP, a multiplexed bead array assay, was used for measurement of 28 growth factors and cytokines.
Results: Values of VEGF and other cytokines were significantly increased in all patient groups. Under anti-VEGF therapy, VEGF levels were significantly reduced in all three patient groups. This effect was measurable over a time period of four weeks after injection. Under consecutive monthly treatment VEGF levels remained low. When treatment was interrupted and signs of disease activity were present, VEGF levels had increased again. Changes of VEGF levels correlated with visual acuity and central retinal thickness. A physiologic expression of VEGF was measurable also in eyes of control patients. Anti-VEGF therapy eliminated also these physiologic VEGF concentrations.
Conclusions: VEGF and other growth factors and cytokines are important pathogenetic mediators in retinal vascular diseases. They are correlated with changes of clinical and functional features. Intravitreal injections of anti-VEGF medication result in a decrease of pathologic and physiologic VEGF levels.

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