title: Effect of intravitreal ranibizumab injections on aqueous humour concentrations of vascular endothelial growth factor and pigment epithelium-derived factor in patients with myopic choroidal neovascularisation.
abstract: OBJECTIVE
  To investigate aqueous humour changes in vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) levels in patients with choroidal neovascularisation (CNV) secondary to pathological myopia (mCNV) before and after intravitreal ranibizumab injection (IVR).
  
  
  METHODS
  This was a prospective, case-control study investigating aqueous levels of VEGF and PEDF in eyes with mCNV treated with IVR.
  
  
  RESULTS
  Mean VEGF and PEDF levels in the aqueous humour of control patients were 25.7±4.9 pg/mL and 12.6±3.5 ng/mL, respectively. Lower levels of both VEGF (19.5±5.4 pg/mL) and PEDF (4.7±2.2 ng/mL) were found in patients with mCNV before IVR. After IVR, aqueous VEGF levels significantly reduced to 6.5±2.7 pg/mL, while PEDF levels significantly increased to 35.8±11.4 ng/mL. VEGF and PEDF levels significantly correlated with each other, and with best-corrected visual acuity and central retinal thickness.
  
  
  CONCLUSIONS
  The VEGF and PEDF levels in aqueous humour were significantly lower in the myopic group than in controls. Moreover, IVR resulted in reduced VEGF and increased PEDF levels in patients with mCNV. In mCNV, neovascularisation is associated with inappropriate VEGF and PEDF expression. A balance between VEGF and PEDF is crucial to prevent CNV development.
  
  
  BACKGROUND
  NCT02175940.
authors.affiliation: Eye Clinic, Department of Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Costagliola
authors.affiliation: Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Semeraro
authors.affiliation: Eye Clinic, Department of Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: dell'Omo
authors.affiliation: Department of Neuroscience, Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Naples, Italy.
authors.forename: Mario R
authors.initials: MR
authors.lastname: Romano
authors.affiliation: Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Brescia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Russo
authors.affiliation: Department of Medicine & Health Sciences, University of Molise, Campobasso, Italy.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Aceto
authors.affiliation: Department of Ophthalmology, University of Verona, Verona, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Mastropasqua
authors.affiliation: Department of Structural and Functional Biology, "Federico II" University of Naples, Naples, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Porcellini
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001082:Aqueous Humor / Q000378:metabolism*; D016022:Case-Control Studies; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005136:Eye Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D009414:Nerve Growth Factors / Q000378:metabolism*; D011446:Prospective Studies; D011480:Protease Inhibitors / Q000378:metabolism; D000069579:Ranibizumab; D015843:Serpins / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000378:metabolism*; D014792:Visual Acuity; D000099174:Pigment Epithelium-Derived Factor
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D005136:Eye Proteins; D009414:Nerve Growth Factors; D011480:Protease Inhibitors; D000069579:Ranibizumab; D015843:Serpins; D042461:Vascular Endothelial Growth Factor A; D000099174:Pigment Epithelium-Derived Factor; C467484:VEGFA protein, human
keywords: PEDF; choroidal neovascularization; pathologic myopia; ranibizumab