Correlated Research Of Concentration Levels Of PEDF And VEGF In Serum And Aqueous Humor Of Patients With Neovascular Glaucoma

Objective: Nonvascular glaucoma (NVG) is a severe angle-closure glaucoma thatbecause of the iris surface and real angle neovascularization combined with a fibrovascular membrane formation leading to angle closure. The formation of the iris andanterior chamber angle neovascularization is due to ischemic and hypoxic stimulationcauses, contains a series of complex pathological processes. Ischemia causesangiogenesis promoting factor and inhibition of vascular factors releasing, if the formeris more effective than the latter, the neovascularization grows.Pigment epithelium derived factor (PEDF) and vascular endothelial growth factor(VEGF) is considered to be a typical representative of the inhibitor and inducer ofangiogenesis. This experiment aims to make further exploration of the mechanism ofthe function of PEDF and VEGF on ocular neovascularization by detecting PEDF andVEGF levels in aqueous humor and serum of NVG patients, providing new ideas forprevention and treatment of ocular neovascularization; trying to find indicators in theserum that reflect corresponding factors in aqueous humor by vascular factor correlationstudy, then study and establish objective indicators that can correctly predict the NVGpathogenesis and disease progress, providing related theoretical basis for early clinicalprediction, assessment of disease severity and prognosis.Results:1. The patientsGroup A: we collect NVG patients20cases (20eyes) in Dalian MedicalUniversity Affiliated Second Hospital Ophthalmology Department from March2011toMarch2012,including male11cases (11eyes), female9cases (9eyes); right eyes12cases, left eyes8cases; age from36years old to85years old, the average age of66.16+ /-15.12years. Preoperative IOP range from21mmHg to94, the average IOP of59.05+21.33mmHg.14cases of diabetic retinopathy (DR),2cases of central retinal veinocclusion (CRVO),4cases of unknown etiology.Group B:20cases (20eyes) of primary chronic angle closure glaucoma patients inDalian Medical University Affiliated Second Hospital Ophthalmology Department inthe same period, including male8cases (8eyes), female12cases (12eyes); right eyes10cases, left eyes10cases; age from49years old to76years old, the average age of60+/-8.96years. Preoperative IOP range from22to71mmHg, the average IOP of45.80+16.79mmHg.Group C:20cases (20eyes) of senile cataract patients in Dalian MedicalUniversity Affiliated Second Hospital Ophthalmology Department in the same period,including male14cases (14eyes), female6cases (6eyes); right eyes9cases, lefteye11cases; age from48years old to76years old, the average age of71.95+/-11.24years. Preoperative IOP range from10to21mmHg, the average IOP of15.90+2.05mmHg.Each age, gender, eye has no significant difference (P>0.05)2. PEDF levelconcentration level of PEDF in aqueous humor: group A217.15+30.12pg/ml islower than group B460.85+1.86pg/ml and C group520.10+9.59pg/ml, among thethree groups, both the differences of pair wise comparison are significant (F=155.01,P <0.05). concentration level of PEDF in serum: group A12.65+7.66mg/L, groupB15.20+2.70mg/L and C group13.35+4.21mg/L, among the three groups, both ofthe differences of pair wise comparison are not significant (P>0.05).3. VEGF levelConcentration level of VEGF in aqueous humor: group A1481.69+88.15pg/ml ishigher than that in group B300.98+53.71pg/ml and C group180.23+15.01pg/ml,among the three groups, both of the differences of pair wise comparison are significant(F=1.63, P <0.05). concentration level of VEGF in serum: group A98.63+6.83pg/ml were lower than group B279.61+94.02pg/ml and C group142.05+34.99pg/ml,among the three groups, both of the differences of pair wise comparison are significant(F=2.66, P <0.05)4. Comparison of PEDF level in aqueous and serum in patients with NVGConcentration level of PEDF in aqueous humor of NVG Patients is lower than thatin serum, the difference is significant (t=7.170, P <0.05), but concentration of PEDF in serum and the corresponding content have no significant correlation (P>0.05)5. Comparison of VEGF level in aqueous and serum in patients with NVGConcentration level of VEGF in aqueous humor of NVG Patients is significantlyhigher in the serum, the difference is significant (t=-20.445, P <0.05), butconcentration of VEGF in serum of corresponding content have no significantcorrelation (P>0.05).6. Correlation of the levels of PEDF and VEGF in aqueous humor in three groupsPEDF and VEGF levels in aqueous humor in three groups are negatively correlated,the difference is significant (r=-0.67, r=-0.58, r=-0.47, P <0.05).Conclusion:1.iris neovascularization of patients with NVG may has relationshipwith the reduction of PEDF level and the increase of VEGF level.2PEDF and VEGF is respectively a vascular inhibitory factor and vascular stimulationfactor, may be an important factor contributing to NVG.