Vitreous Levels of Pigment Epithelium–Derived Factor and Vascular Endothelial Growth Factor Are Related to Diabetic Macular Edema
Received 12 December 2004; accepted 20 October 2005. published online 09 January 2006.
Purpose
To investigate whether vitreous levels of vascular endothelial growth factor (VEGF) and pigment epithelium–derived factor (PEDF) are related to diabetic macular edema (DME).
Design
Retrospective case–control study.
Participants
Thirty-six patients with DME, 6 diabetic patients without retinopathy, and 13 patients with nondiabetic ocular disease.
Methods
After vitreous fluid samples were obtained at vitreoretinal surgery, VEGF and PEDF levels in the vitreous fluid were measured by enzyme-linked immunosorbent assay.
Main Outcome Measures
Correlations between vascular permeability and the vitreous fluid levels of VEGF and PEDF.
Results
The vitreous level of VEGF was significantly higher in patients with DME than in nondiabetic patients and diabetic patients without retinopathy (P<0.0001 and P<0.0001, respectively). Conversely, the vitreous level of PEDF was significantly lower in patients with DME than in nondiabetic patients and diabetic patients without retinopathy (P<0.0001 and P<0.0001, respectively). The vitreous level of PEDF did not correlate significantly with that of VEGF (P = 0.1806). The vitreous level of VEGF was significantly higher in patients with hyperfluorescent DME than in those with minimally fluorescent DME (P = 0.0022). Conversely, the vitreous PEDF level was significantly lower in patients with hyperfluorescent DME than in those with minimally fluorescent DME (P = 0.0172). Vitreous levels of VEGF and PEDF were related to the retinal thickness at the central fovea (P<0.0001 and P = 0.0469, respectively).
Conclusions
Our retrospective study suggests that VEGF and PEDF have an independent association with vascular permeability in the eye and on the DME, and we recommend that prospective validation of our findings be undertaken to confirm these observations.
1Department of Ophthalmology, Diabetes Center, Tokyo Women’s Medical University, Tokyo, Japan
2Department of Ophthalmology and Visual Science, Yamagata University School of Medicine, Yamagata, Japan
3Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
4Department of Ophthalmology, Eguchi Eye Hospital, Hakodate, Japan
5Department of Ophthalmology and Visual Science, Hiroshima University School of Medicine, Hiroshima, Japan
6Department of Ophthalmology, Tokyo Women’s Medical University, Tokyo, Japan
Correspondence to Hideharu Funatsu, MD, Department of Ophthalmology, Diabetes Center, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
Manuscript no. 2004-397.
Supported by the Japanese Ministry of Health, Labor and Welfare, Tokyo, Japan (Health Science Research Grant no.: 10060101 [SH, HF, HY]).
The authors have no proprietary interest in any of the materials or techniques used in the study.
ABSTRACT