Vitreous levels of pigment epithelium-derived factor and vascular endothelial growth factor are related to diabetic macular edema.
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.
Funatsu
Hideharu
H
Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan. tfunatsu@nifty.com
Yamashita
Hidetoshi
H
Nakamura
Shinko
S
Mimura
Tatsuya
T
Eguchi
Shuichiro
S
Noma
Hidetaka
H
Hori
Sadao
S
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
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