新生血管性青光眼患者眼内血管内皮生长因子浓度对虹膜新生血管的影响

The effect of the levels of the vascular endothelial growth factor in ocular fluid of patients with neovascular glaucoma on the neovascularization of iris

目的 观测手术前后新生血管性青光眼 (neovascular glaucoma,NVG)患者房水及玻璃体中血管内皮生长因子 (vascular endothelial growth factor,VEGF)含量变化 ,及对 NVG虹膜新生血管的影响。方法 应用酶联免疫吸附测定法 (enzyme linked im munosorbent assay,EL ISA)对 18例 NVG患者内眼手术前后取得的 72份房水、玻璃体标本进行 VEGF检测对比 ,观察手术前后虹膜新生血管的消退情况。结果 NVG患者手术后房水中VEGF含量为 (0 .5 76± 0 .196) ng/ml,较手术前房水 VEGF含量 (1.486± 0 .3 2 2 ) ng/ml明显降低 (t=10 .3 94,P<0 .0 0 1) ,而玻璃体中的 VEGF含量由 (1.619± 0 .3 84) ng/ml降为 (0 .682± 0 .2 2 2 ) ng/m l(t=9.3 93 ,P <0 .0 0 1) ,两组间差别均有非常显著性意义。术后发现两周内 77.78% (14/18)患者虹膜新生血管消退。结论 NVG患者虹膜新生血管形成及维持可能依赖于房水、玻璃体中 VEGF含量 ,手术后眼内

Objective To detect the fluctuation of the levels of the vascular endothelial growth factor (VEGF) in ocular fluid of patients with neovascular glaucoma (NVG) after and before the surgery and investigate the effect of the fluctuation of VEGF on the neovascularization of iris.Methods 72 samples of aqueous and vitreous obtained from 18 patients with NVG after and before the surgery were collected,The Concentration of VEGF were measured by using enzyme linked immunosobent assay (ELISA) for quantitative analysis.The neovascularization of iris was observed for 4 weeks at least.Results Preopratively the mean (±SD) VEGF concentration of the aqueous humor and vitreous from patients with NVG were 1.486±0.322ng/ml and 1.619±0.384ng/ml,Postoperatively the concentration of VEGF of the aqueous humor and vitreous declined to 0.576±0.196ng/ml and 0.682±0.222ng/ml respectively.There was a significant difference between the two groups statisticaly(t=10.394,P<0.001,and t=9.393,P<0.001 respectively,Primer t term=Neovascular iris vessels in 14 of 18(77.78%) patients with NVG regressed in two weeks postoperatively.Conclusions The development and maintenance of iris neovascularization could depends on the levels of VEGF,decline of VEGF by diluting intraocular fluid in sugery might play an important role in regression of neovascular iris vessels.