title: Evaluation of plasma vascular endothelial growth factor levels after intravitreal injection of ranibizumab and aflibercept for exudative age-related macular degeneration.
abstract: BACKGROUND
  To evaluate the plasma vascular endothelial growth factor (VEGF) levels after one intravitreal injection of aflibercept or ranibizumab in patients with exudative age-related macular degeneration (AMD).
  
  
  METHODS
  Twenty-four Japanese with exudative AMD, polypoidal choroidal vasculopathy, and retinal angiomatous proliferation were included. Fourteen patients received an intravitreal injection of aflibercept, and ten patients received an intravitreal injection of ranibizumab. Plasma VEGF levels were evaluated within 7 days before the intravitreal injections and 1 day, 1 week, and 1 month after the intravitreal injection.
  
  
  RESULTS
  In the ranibizumab group, the mean plasma VEGF levels were 245.7 ± 233.4 pg/ml before the injection, 246.6 ± 304.8 pg/ml after 1 day, 217.8 ± 212.9 pg/ml after 1 week, and 260.0 ± 290.1 pg/ml after 1 month. The plasma VEGF levels did not decrease significantly in patients in the ranibizumab group at any time point. In the aflibercept group, the mean plasma VEGF levels were 280.0 ± 170.3 pg/ml before the intravitreal injection and 8.2 ± 12.9 pg/ml after 1 day, 9.1 ± 9.1 pg/ml after 1 week, and 41.9 ± 41.4 pg/ml after 1 month (p < 0.0001, vs before injection).
  
  
  CONCLUSIONS
  Intravitreally injected aflibercept reduced plasma VEGF over at least 1 month. In contrast, intravitreal injection of ranibizumab did not cause a significant reduction in the plasma VEGF levels.
authors.affiliation: Department of Ophthalmology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Chiba, Sakura, 285-8741, Japan.
authors.forename: Izumi
authors.initials: I
authors.lastname: Yoshida
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Shiba
authors.forename: Hikari
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Mao
authors.initials: M
authors.lastname: Takahashi
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Murano
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hiruta
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hori
authors.forename: Hdieaki
authors.initials: H
authors.lastname: Bujo
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Maeno
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D004797:Enzyme-Linked Immunosorbent Assay; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D009887:Ophthalmoscopy; D000069579:Ranibizumab; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D057135:Wet Macular Degeneration / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab