title: Vitreous levels of pigment epithelium-derived factor and vascular endothelial growth factor are related to diabetic macular edema.
abstract: OBJECTIVE
  To investigate whether vitreous levels of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) are related to diabetic macular edema (DME).
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan. tfunatsu@nifty.com
authors.forename: Hideharu
authors.initials: H
authors.lastname: Funatsu
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Yamashita
authors.forename: Shinko
authors.initials: S
authors.lastname: Nakamura
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Mimura
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Eguchi
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Noma
authors.forename: Sadao
authors.initials: S
authors.lastname: Hori
mesh_terms: D002199:Capillary Permeability; D016022:Case-Control Studies; D003930:Diabetic Retinopathy / Q000378:metabolism* / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005136:Eye Proteins / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D017075:Laser Coagulation; D008269:Macular Edema / Q000378:metabolism* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000378:metabolism*; D012189:Retrospective Studies; D015843:Serpins / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D014821:Vitrectomy; D014822:Vitreous Body / Q000378:metabolism*; D000099174:Pigment Epithelium-Derived Factor
chemical_list: D005136:Eye Proteins; D006442:Glycated Hemoglobin; D009414:Nerve Growth Factors; D015843:Serpins; D042461:Vascular Endothelial Growth Factor A; D000099174:Pigment Epithelium-Derived Factor; C467484:VEGFA protein, human