Levels of VEGF but not VEGF165b are Increased in the Vitreous of Patients With Retinal Vein Occlusion

Purpose To determine the concentration of the pro-angiogenic vascular endothelial growth factor VEGF165 (VEGF) and the anti-angiogenic VEGF165b in vitreous samples of patients with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) in comparison to patients without retinal occlusive disease. Design Experimental laboratory investigation. Methods Vitreous samples were collected from patients undergoing surgery for arteriovenous dissection after BRVO, radial optic neurotomy after CRVO in the occlusion group, or macular pucker or macular hole in the control group. Concentrations of VEGF and VEGF165b were determined by ELISA and an ELISA-type antibody microarray. Results Average vitreal concentration of VEGF was 8.6 ng/mL in the CRVO group and 2.0 ng/mL in the BRVO group as compared to 0.26 ng/mL in the control group. Average vitreal concentration of VEGF165b was 27 pg/mL in the CRVO group, 42 pg/mL in the BRVO group, and 49 pg/mL in the control group. In patients with CRVO and BRVO, the angiogenic balance was shifted towards angiogenic stimulation. Conclusion The severity of RVO from BRVO to CRVO correlates with an increase of VEGF and the decrease of VEGF165b , indicating a pro-angiogenic shift. Altering the ratio of VEGF165b /VEGF165 might be a feasible approach for treating retinal occlusive diseases.