Vitreous concentrations of vascular endothelial growth factor as a potential biomarker for postoperative complications following pars plana vitrectomy

Abstract

A b s t r a c tIntroduction: The aim of the study was to investigate the effects of vascular endothelial growth factor (VEGF) concentration in vitreous on postoperative complications after pars plana vitrectomy (PPV). Material and methods: Ninety subjects were surgically treated with PPV and followed up for 12 months at the Clinical Centre University Sarajevo, Clinic for Eye Disease. Exclusion criteria were presence of other eye diseases, systemic acute/chronic inflammatory conditions, or malignant neoplasms; previously performed PPV surgery; previously received intravitreal or systemic anti-VEGF therapy. A vitreous sample was obtained while performing the PPV procedure, using the Quantikine ELISA test to determine VEGF level, as a risk factor. Outcome measures were intraoperative and postoperative complications reported using categorical data: blunt and sharp dissection of membranes, intraoperative hemorrhage stopped by increasing infusion pressure, pressing with blunt instrument, or using diathermy. The following postoperative complications were assessed on the first day and at the 12-month follow-up visit: vitreous hemorrhage, fibrovascular proliferation (FVP), rubeosis iridis, and neovascular glaucoma (NVG). Results: Levels of vitreous VEGF at the time of PPV were significantly higher in eyes with: vitreous hemorrhage on the first day after PPV (p = 0.003); FVP on the first day and 12 months after PPV (p = 0.002 and p < 0.001, respectively); iris rubeosis on the first day and 12 months after PPV surgery (p < 0.001, and p = 0.001, respectively); NVG on the first day and 12 months after PPV surgery (p = 0.043 and p = 0.011, respectively), compared to the eyes without complications. Conclusions: Preoperative levels of VEGF in vitreous can be a useful biomarker and predictor of the postoperative outcome in terms of intraoperative and postoperative complications.

Effect of pan-retinal laser photocoagulation on intravitreal vascular endothelial growth factor concentration in proliferative diabetic retinopathy

“…The reasons for not performing PRP pre-treatment in group B included the inability of performance due to decreased transparency of optical media (cataract or haematovitreus), the presence of tractional retinal detachment (TRD) with macular involvement, severe fibrovascular proliferation, and the presence of preretinal or epiretinal membranes or other mechanical components that could only be resolved during PPV. Many other researches also confirm the importance of PRP pre-treatment [ 13 , 14 ]. Bakhritdinova et al highly embrace preoperative PRP due to stabilization of proliferative processes, prevention of vitreomacular traction (VMT) formations, thus keeping the anatomical relations and visual acuity more stable [ 14 ].…”

“…Anti-VEGF has also proven to be very successful preoperatively and intraoperatively due to significant decrease of intraoperative and postoperative haemorrhage [ 21 ]. It was also reported that VEGF concentration can be used as a predictive factor for certain postoperative complications, such as vitreous haemorrhage or glaucoma [ 13 , 14 ].…”

“…Wang et al have reported that progressive forms of PDR have higher concentrations of VEGF compared to both less progressive disease and to control group [ 13 ]. Our results confirmed their conclusions as we have shown that PDR patients have significantly higher vitreous VEGF concentration compared to the control group.…”

Usefulness of Liquid Biopsy Biomarkers from Aqueous Humor in Predicting Anti-VEGF Response in Diabetic Macular Edema: Results of a Pilot Study

“…A volume of ≈ 0.1 mL of AH was obtained using a limbal approach with a 30 gauge needle. In 7 out of 38 patients, 1–2 mL of vitreous fluid was also obtained during 23 gauge pars plana vitrectomy [17]. The samples were immediately transferred to sterile plastic tubes, frozen, and stored at −80° until the analyses.…”

Comparison of Ex-PRESS P-200 mini-shunt implantation and standard trabeculectomy for open-angle glaucoma: four-year follow-up

“…One of the most important causes of blindness is glaucoma, an age-related disease that can lead to blindness without appropriate medical treatment [1]. The visual impairment could also occur after eye surgical treatment, the risk being also related to the health status of the subject [2][3][4].…”