| ObjectiveBy detecting and analyzing the changes of insulin-like growth factor-1(IGF-1)and insulin-like growth factor binding protein-3(IGFBP-3)in the serum of patients with wet age-related macular degeneration(wAMD)during anti-vascular endothelial growth factor(VEGF)treatment,to explore the significance of changes of IGF-1 and IGFBP-3 in the treatment of wAMD patients and the analysis of treatment effect.MethodsSelect 40 patients with wAMD confirmed in the ophthalmology department of the Affiliated Hospital of Nantong University of Jiangsu Province from October 2021 to October 2022 as the study subjects,and the control group is 40 patients with age-related cataract(ARC)included in the same period.General clinical data of all enrolled patients were recorded,including age,gender,body mass index(BMI),drinking history,smoking history,diabetes and hypertension history.The treatment plan of wAMD patients is intravitreal ranibizumab injection,once a month,for three consecutive months.Before the operation,the optical coherence tomography(OCT),internal pressure(IOP)and best corrected visual acuity(BCVA)examinations were performed,and the OCT,IOP and BCVA were re-examined four weeks after each operation.According to the double antibody sandwich enzyme-linked immunosorbent assay(ELISA),4ml of elbow vein blood was drawn to detect the concentration of IGF-1 and IGFBP-3 in serum before three injections in wAMD group and cataract surgery in ARC group.SPSS26.0 software and Graph Pad Prism9.0 software were used for statistical analysis.Two independent sample t-test and chi-square test were used for comparison between the two groups.Repeated measurement analysis of variance and nonparametric Friedman test were used for comparison of multiple measurement results.If the repeated measurement analysis of variance is not satisfied with the football shape,the Greenhouse-Geisser method is used for correction.The LSD method was used for the comparison of two after the event.Pearson correlation analysis was used for the correlation between the two-measurement data.Results1.Firstly,the influence of age and sex in wAMD group and ARC group was excluded.Before the first intravitreal injection of ranibizumab,the average serum IGF-1concentration(192.58±40.24ng/ml)in wAMD group was significantly higher than that in ARC group(157.41±43.60ng/ml),and the average serum IGFBP-3 concentration(3680.82±587.99ng/ml)was significantly higher than that in ARC group(2979.10±489.07ng/ml),with statistically significant differences(P < 0.001).2.The average concentration of serum IGF-1 in wAMD group before three injections was 192.58±40.24ng/ml,179.07±44.91ng/ml,170.02±45.23ng/ml respectively,the difference was statistically significant(P < 0.001),and the concentration before the first injection > the concentration before the second injection > the concentration before the third injection.The average concentration of serum IGFBP-3 in wAMD group before three injections was 3680.82±587.99ng/ml,3456.61±757.64ng/ml and3209.63±840.97ng/ml respectively,with a statistically significant difference(P < 0.001),and the concentration before the first injection > the concentration before the second injection > the concentration before the third injection.3.The baseline value of central foveal thickness(CFT)in the wAMD group(354.97±42.92μm)> 1 month value(337.48±45.69μm)> 2 months value(330.15±43.01μm)> 3 months value(319.73±48.45μm),and the difference was statistically significant(P < 0.001).BCVA log MAR unit baseline value(0.84±0.44)> 1-month value(0.78±0.40)> 2-month value(0.71±0.38)> 3-month value(0.65±0.34),and the difference was statistically significant(P < 0.001).There was no statistically significant difference in IOP baseline value,1-month value,2-month value and 3-month value(P > 0.05).4.Pearson correlation analysis was performed on IGF-1 concentration before three injections and the baseline value,1-month value and 2-month value of CFT respectively,and the results were positively correlated and statistically significant(r = 0.551,0.665,0.628,P < 0.001);Pearson correlation analysis of IGF-1 concentration and BCVA(log MAR)baseline value,1-month value and 2-month value before three injections showed positive correlation and statistically significant(r = 0.824,0.782,0.809,P <0.001).Pearson correlation analysis was performed on IGFBP-3 concentration before three injections and the baseline value,1-month value and 2-month value of CFT respectively,and the results were positively correlated and statistically significant(r =0.414,0.478,0.441,P < 0.01);Pearson correlation analysis of IGFBP-3 concentration and BCVA(log MAR)baseline value,1-month value and 2-month value before three injections showed positive correlation and statistical significance(r = 0.690,0.634,0.549,P < 0.001).5.Pearson correlation analysis of IGF-1 concentration before three injections and IGFBP-3 concentration before three injections showed positive correlation and statistical significance(r = 0.532,0.577,0.667,P < 0.001).Conclusions1.The serum levels of IGF-1 and IGFBP-3 in patients with wet age-related macular degeneration were significantly higher than those in patients with age-related cataract.2.Intravitreal injection of ranibizumab can reduce the concentration of IGF-1 and IGFBP-3 in the serum of patients with wet age-related macular degeneration,and the changes of IGF-1 and IGFBP-3 levels are positively correlated with the treatment effect of patients.3.Monitoring the changes of IGF-1 and IGFBP-3 concentrations in serum can provide a certain basis for the detection of neovascularization and further anti-vascular treatment in patients with wet age-related macular degeneration. |
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