INCREASED LEVEL OF VASCULAR ENDOTHELIAL GROWTH-FACTOR IN AQUEOUS-HUMOR OF PATIENTS WITH NEOVASCULAR GLAUCOMA

Purpose: This study aimed to quantitate and compare the concentration of vascular endothelial growth factor (VEGF) in aqueous humor samples from patients with neovascular glaucoma (NVG), primary open-angle glau coma (POAG), and cataract, as well as in serum samples of healthy huma n subjects. Methods: The authors collected aqueous humor samples by us ing their previously published technique of limbal paracentesis. The a uthors determined the concentration of VEGF by using a competitive enz yme immunoassay system and four-parameter logistic curve fitting and p erformed statistical analysis by using the Mann-Whitney-Wilcoxon test. Results: The authors detected VEGF in 12 of 12 samples from patients with NVG (mean +/- standard error of the mean, 29.267 +/- 7.350 ng/ml) , 15 of 28 samples from patients with POAG (0.726 +/- 0.204 ng/ml), 4 of 20 aqueous humor samples from patients with cataract (0.257 +/- 0.0 43 ng/ml), and 16 of 16 human serum samples (20.246 +/- 1.568 ng/ml). The mean concentration of VEGF in aqueous humor of patients with NVG w as 40- and 113-fold higher than that in patients with POAG and catarac t, respectively, and the difference was statistically significant (P < 0.01). The VEGF level in patients with POAG was elevated compared wit h that in patients with cataract (P < 0.05). Although the mean concent ration of VEGF in aqueous humor of patients with NVG was approximately 1.45-fold higher than that in serum, the difference was not significa nt (P > 0.05). Conclusion: The authors' findings show that patients wi th NVG had a significantly increased level of VEGF in the aqueous humo r and implicate VEGF as an important factor in the pathogenesis of int raocular neovascularization in these patients. The authors discuss the possible role of the ciliary epithelium, in addition to retina, in th e production of VEGF and the complementary function of basic fibroblas t growth factor and other growth factors.