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PLASMA CONCENTRATIONS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN RETINOPATHY OF PREMATURITY AFTER INTRAVITREAL
Yoo Rha Hong1, Young Ho Kim, Soo Young Kim
1Departments of *Pediatrics, and †Molecular Biology, College of Medicine, Kosin University, Busan, South Korea; ‡BNG Eye Clinic, Busan, South Korea; §Department of Ophthalmology, Institute of Medicine, College of Medicine, Kosin University, Busan, South Korea; and ¶Gongjoo St. Mary's Eye Clinic, Gongjoo City, South Korea.
Insights
Intravitreal bevacizumab injections significantly lower vascular endothelial growth factor (VEGF) in infants with retinopathy of prematurity. Plasma VEGF levels remained reduced for up to 8 weeks, while other factors showed no significant changes.
Area of Science:
- Ophthalmology
- Neonatology
- Pharmacology
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Vascular endothelial growth factor (VEGF) plays a critical role in the pathogenesis of ROP.
- Bevacizumab is a VEGF inhibitor used off-label for ROP treatment.
Purpose of the Study:
- To evaluate the impact of intravitreal bevacizumab on systemic plasma concentrations of VEGF and other growth factors in infants with ROP.
- To determine the duration of VEGF reduction following intravitreal bevacizumab injection.
Main Methods:
- Plasma samples were collected from 6 infants (11 eyes) with ROP before and up to 8 weeks after intravitreal bevacizumab injection.
- Concentrations of VEGF, IGF-1, erythropoietin, PEDF, and IgG1 were measured using ELISA.
- Infants had a mean gestational age of 26 weeks and birth weight of 870g.
Main Results:
- Plasma VEGF concentration significantly decreased from 2.05 ng/mL pre-injection to 0.16 ng/mL at 1 week and 0.14 ng/mL at 2 weeks post-injection (P=0.028).
- VEGF levels remained significantly suppressed for the 8-week study period.
- Plasma concentrations of IGF-1, erythropoietin, PEDF, and IgG1 showed no significant changes.
Conclusions:
- Intravitreal bevacizumab effectively reduces systemic VEGF levels in infants with ROP.
- The observed reduction in VEGF is sustained for at least 7 weeks.
- Bevacizumab treatment for ROP does not appear to systemically affect other measured growth factors.
Purpose:
To investigate the changes in plasma concentrations of vascular endothelial growth factor (VEGF), insulin growth factor (IGF-1), erythropoietin, pigment epithelium-derived factor, and IgG1 after bevacizumab intravitreal injection in infants with retinopathy of prematurity.
Methods:
Eleven eyes from six infants who received intravitreal injection of bevacizumab were enrolled in this study. At preinjection and postinjection 1, 2, 3, 4, 5, 6, 7, and 8 weeks, 0.5 mL of blood was collected from each infant. The plasma concentrations of VEGF, insulin growth factor, erythropoietin, pigment epithelium-derived factor, and IgG1 were measured by enzyme-linked immunosorbent assay. Five patients received simultaneous bilateral bevacizumab injection; one patient received unilateral injection.
Results:
Of the infants who received intravitreal bevacizumab injection, two were males and four were females. The mean gestational age was 26 ± 2 weeks. The mean birth weight was 870 g. The mean plasma VEGF concentration before bevacizumab injection was 2.05 ± 3.00 ng/mL; plasma level decreased significantly to 0.16 ± 0.10 ng/mL and to 0.14 ± 0.14 ng/mL (P = 0.028) after 1 week and 2 weeks, respectively. Moreover, the plasma concentrations of VEGF did not return to the original level in any of the samples until 8 weeks after the injection. However, mean plasma IgG1, erythropoietin, insulin growth factor, and PEDF concentrations did not change significantly during the interval between preinjection and any other follow-up time points.
Conclusion:
Intravitreal bevacizumab injections significantly reduce plasma VEGF concentration in infants with retinopathy of prematurity over a 7-week period.
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