Results of Anti-VEGF Therapy in the Treatment of Post-vitrectomy Vitreous Hemorrhage in Patients with Proliferative Diabetic Retinopathy

2021 ◽  
pp. 97-103
Author(s):  
O. O. Putiienko
Keyword(s):  
Diabetic Retinopathy ◽  
Gas Exchange ◽  
Recurrence Rate ◽  
Proliferative Diabetic Retinopathy ◽  
Treatment Options ◽  
Vitreous Hemorrhage ◽  
Main Group ◽  
Control Group ◽  
Anti Vegf ◽  
Significant Difference

Post-vitrectomy vitreous hemorrhage in patients with proliferative diabetic retinopathy (PDR) occurs in up to 75% of cases, and this highlights the need to search for new treatment options. The aim. To analyze the results of anti-VEGF therapy in the treatment of post-vitrectomy vitreous hemorrhage in patients with PDR. Materials and methods. Seventy-eight patients (78 eyes) were examined. Twenty patients (20 eyes) of the control group underwent outpatient fluid gas exchange (OFGE) with 20% gas-air mixture of perfluoropropane for the treatment of post-vitrectomy vitreous hemorrhage. The first main group included 28 patients in whom OFGE with the same mixture was supplemented by the injection of Lucentis at a dose of 0.5 mg into the vitreous cavity. The second main group included 30 patients who achieved Eylea at a dose of 2 mg in addition to the OFGE. Results. Within 2 months, no significant difference between groups in achieving vitreous transparency or in vitreous hemorrhage recurrence rate was found. After 6 months, the frequency of vitreous hemorrhage recurrence in the control group was significantly higher (χ2 = 4.27; p = 0.039) than that in the Lucentis group (9 eyes [45%] vs. 3 eyes [10.7%]). When using Eylea in the same period, the recurrence rate was 6.7% (2 eyes) which is significantly lower than 45% (9 eyes) in the control group (χ2 = 4.59; p = 0.032). Conclusions. The effectiveness of treatment of post-vitrectomy vitreous hemorrhage by OFGE with 20% gas-air mixture of perfluoropropane within 6 months of observation is 85.5%. The use of Lucentis increases the effectiveness to 92.8% with a recurrence rate of 10.7%, and the use of Eylea to 96.6% with a recurrence rate of 6.7%. There are no significant differences between the use of Lucentis and Eylea. Keywords: proliferative diabetic retinopathy, post-vitrectomy vitreous hemorrhage, outpatient fluid gas exchange, Lucentis, Eylea.

Proteomic Analysis of the Vitreous Body in Proliferative and Non-Proliferative Diabetic Retinopathy

2020 ◽  
Vol 17 ◽  
Author(s):  
Van-An Duong ◽  
Jeeyun Ahn ◽  
Na-Young Han ◽  
Jong-Moon Park ◽  
Jeong-Hun Mok ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Microvascular Complications ◽  
Treatment Options ◽  
Vitreous Body ◽  
Control Group ◽  
Diabetic Patients ◽  
Protein Protein Interaction ◽  
Alpha Beta ◽  
New Treatment

Background: Diabetic Retinopathy (DR), one of the major microvascular complications commonly occurring in diabetic patients, can be classified into Proliferative Diabetic Retinopathy (PDR) and Non-Proliferative Diabetic Retinopathy (NPDR). Currently available therapies are only targeted for later stages of the disease in which some pathologic changes may be irreversible. Thus, there is a need to develop new treatment options for earlier stages of DR through revealing pathological mechanisms of PDR and NPDR. Objective: The purpose of this study was to characterize proteomes of diabetic through quantitative analysis of PDR and NPDR. Methods: Vitreous body was collected from three groups: control (non-diabetes mellitus), NPDR, and PDR. Vitreous proteins were digested to peptide mixtures and analyzed using LC-MS/MS. MaxQuant was used to search against the database and statistical analyses were performed using Perseus. Gene ontology analysis, related-disease identification, and protein-protein interaction were performed using the differential expressed proteins. Results: Twenty proteins were identified as critical in PDR and NPDR. The NPDR group showed different expressions of kininogen-1, serotransferrin, ribonuclease pancreatic, osteopontin, keratin type II cytoskeletal 2 epidermal, and transthyretin. Also, prothrombin, signal transducer and activator of transcription 4, hemoglobin subunit alpha, beta, and delta were particularly up-regulated proteins for PDR group. The up-regulated proteins related to complement and coagulation cascades. Statherin was down-regulated in PDR and NPDR compared with the control group. Transthyretin was the unique protein that increased its abundance in NPDR compared with the PDR and control group. Conclusion: This study confirmed the different expressions of some proteins in PDR and NPDR. Additionally, we revealed uniquely expressed proteins of PDR and NPDR, which would be differential biomarkers: prothrombin, alpha-2-HS-glycoprotein, hemoglobin subunit alpha, beta, and transthyretin.

scholarly journals Identification of Diagnostic and Prognostic microRNAs for Recurrent Vitreous Hemorrhage in Patients with Proliferative Diabetic Retinopathy

2019 ◽  
Vol 8 (12) ◽  
pp. 2217 ◽  
Author(s):  
Parviz Mammadzada ◽  
Juliette Bayle ◽  
Johann Gudmundsson ◽  
Anders Kvanta ◽  
Helder André
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Control Group ◽  
Ocular Tissues ◽  
Recurrent Hemorrhage ◽  
Pars Plana ◽  
And Control ◽  
Insight Into ◽  
Recurrent Vitreous Hemorrhage

MicroRNAs (miRNAs) can provide insight into the pathophysiological states of ocular tissues such as proliferative diabetic retinopathy (PDR). In this study, differences in miRNA expression in vitreous from PDR patients with and without incidence of recurrent vitreous hemorrhage (RVH) after the initial pars-plana vitrectomy (PPV) were analyzed, with the aim of identifying biomarkers for RVH. Fifty-four consented vitreous samples were analyzed from patients undergoing PPV for PDR, of which eighteen samples underwent a second surgery due to RVH. Ten of the sixty-six expressed miRNAs (miRNAs-19a, -20a, -22, -27a, -29a, -93, -126, -128, -130a, and -150) displayed divergences between the PDR vitreous groups and to the control. A significant increase in the miRNA-19a and -27a expression was determined in PDR patients undergoing PPV as compared to the controls. miRNA-20a and -93 were significantly upregulated in primary PPV vitreous samples of patients afflicted with RVH. Moreover, this observed upregulation was not significant between the non-RVH and control group, thus emphasizing the association with RVH incidence. miRNA-19a and -27a were detected as putative vitreous biomarkers for PDR, and elevated levels of miRNA-20a and -93 in vitreous with RVH suggest their biomarker potential for major PDR complications such as recurrent hemorrhage incidence.

scholarly journals A Randomized Controlled Trial of Conbercept Pretreatment before Vitrectomy in Proliferative Diabetic Retinopathy

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaochun Yang ◽  
Jianbiao Xu ◽  
Ruili Wang ◽  
Yan Mei ◽  
Huo Lei ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Controlled Trial ◽  
Control Group ◽  
Intraoperative Bleeding ◽  
Significant Difference ◽  
Pars Plana ◽  
Effective Adjunct

Purpose.To determine the efficacy and safety of preoperative intravitreal conbercept (IVC) injection before vitrectomy for proliferative diabetic retinopathy (PDR).Methods.107 eyes of 88 patients that underwent pars plana vitrectomy (PPV) for active PDR were enrolled. All patients were assigned randomly to either preoperative IVC group or control group. Follow-up examinations were performed for three months after surgery. The primary bioactivity measures were severity of intraoperative bleeding, incidence of early and late recurrent VH, vitreous clear-up time, and best-corrected visual acuity (BCVA) levels. The secondary safety measures included intraocular pressure, endophthalmitis, rubeosis, tractional retinal detachment, and systemic adverse events.Results.The incidence and severity of intraoperative bleeding were significantly lower in IVC group than in the control group. The average vitreous clear-up time of early recurrent VH was significantly shorter in IVC group compared with that in control group. There was no significant difference in vitreous clear-up time of late recurrent VH between the two groups. Patients that received pretreatment of conbercept had much better BCVA at 3 days, 1 week, and 1 month after surgery than control group. Moreover, both patients with improved BCVA were greater in IVC group than in control group at each follow-up.Conclusions.Conbercept pretreatment could be an effective adjunct to vitrectomy in accelerating postoperative vitreous clear-up and acquiring stable visual acuity restoration for PDR.

scholarly journals Incidence and Risk Factors for Tractional Macular Detachment after Anti-Vascular Endothelial Growth Factor Agent Pretreatment before Vitrectomy for Complicated Proliferative Diabetic Retinopathy

2019 ◽  
Vol 8 (11) ◽  
pp. 1960
Author(s):  
Andrea Russo ◽  
Antonio Longo ◽  
Teresio Avitabile ◽  
Vincenza Bonfiglio ◽  
Matteo Fallico ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vascular Endothelial Growth Factor ◽  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Vascular Endothelial ◽  
Macular Detachment ◽  
Anti Vegf ◽  
Endothelial Growth Factor

The study’s purpose was to determine the incidence, risk factors, and outcomes of tractional macular detachment after anti-vascular endothelial growth factor (VEGF) pretreatment before vitrectomy for complicated proliferative diabetic retinopathy. Patients who underwent primary vitrectomy for complicated proliferative diabetic retinopathy, from January 2012 to 31 December 2018, were enrolled. Ophthalmic and pre-operative data were extracted from electronic record systems. All eyes with a valuable Optical Coherence Tomography (OCT)performed within 5 days before injection of anti-VEGF and on the day of vitrectomy were included. Multivariable logistic regression showed that significant risk factors for developing tractional macular detachment included days between anti-VEGF and vitrectomy (OR, 0.71 [95% CI 0.65–0.76]; p < 0.001), vitreous hemorrhage (OR, 0.23 [95% CI 0.11–0.49]; p < 0.001), and age (OR, 1.05 [95% CI 1.02–1.08]; p < 0.001). Decision-tree analysis showed that the stronger predictors of tractional macular detachment were the time between anti-VEGF injection and vitrectomy (p < 0.001). Secondary predictors were the presence of vitreous hemorrhage (p = 0.012) in eyes that underwent vitrectomy between 6 and 10 days after anti-VEGF injection and younger age (p = 0.031) in eyes that underwent vitrectomy 10 days after anti-VEGF injection. Tractional macular detachment occurs in 10% of eyes after anti-VEGF injection, the main risk factors being days between anti-VEGF injection and vitrectomy, vitreous hemorrhage, and age.

scholarly journals Effects of Intra-vitreal Injection of Bevacizumab as an Adjunct during Phacoemulsification in Diabetic Maculopathy

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Ali Afzal Bodla ◽  
Syeda Minahil Kazmi ◽  
Noor Tariq ◽  
Ayema Moazzam ◽  
Muhammad Muneeb Aman
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Macular Thickness ◽  
Control Group ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Post Surgery ◽  
Significant Difference

Purpose:  To study the effects of Intra-vitreal injection of Bevacizumab as an adjunct during phacoemulsification in patients with diabetic retinopathy. Study Design:  Quasi experimental study. Methods:  Hundred diabetic patients who were scheduled to undergo phacoemulsification were included in the study. They were equally divided into two groups; Bevacizumab and control group. Complete ocular examination and macular thickness and volume were determined using an OPTOVUE-OCT machine. The patients in the Bevacizumab group were given intra-vitreal injection of 1.25 mg/0.05ml of Bevacizumab at the time of Phacoemulsification. A written ethical approval was obtained and the study was conducted according to principles of declaration of Helsinki. Results:  The bevacizumab group manifested low value of CMT one month post-surgery as compared to the control group (262.2 ± 32.2 and 288.5 ± 54.1, respectively) with P = 0.01. The Total Macular volume, and Best-corrected visual acuity in the two groups showed no significant difference one month after surgery. Amongst the patients who developed postsurgical macular edema, four patients did not possess a positive history for diabetic retinopathy and 3 of them had Non Proliferative Diabetic Retinopathy. We found no significant relationship between the post-surgical macula edema with the presence of mild Non Proliferative Diabetic Retinopathy. (Fisher's test, P = 0.321). Conclusion:  The ocular anti-VEGF therapy substantially reduces macular edema secondary to post-surgical inflammation in diabetic patients. It effectively reduces the central macular thickness although the results are not found to be statistically significant when compared with the control group. Key Words:  Diabetes mellitus; diabetic macular edema; diabetic retinopathy: Bevacizumab.

Increased Vitreous Chemerin Levels Are Associated with Proliferative Diabetic Retinopathy

2016 ◽  
Vol 236 (2) ◽  
pp. 61-66 ◽  
Author(s):  
Jun Li ◽  
Wen-chao Hu ◽  
Hui Song ◽  
Jing-na Lin ◽  
Xin Tang
Keyword(s):  
Diabetic Retinopathy ◽  
Western Blot ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Macular Holes ◽  
Group A ◽  
Group B ◽  
Endothelial Growth Factor

Purpose: To investigate chemerin in the vitreous bodies of patients with proliferative diabetic retinopathy (PDR) and determine the correlation between the levels of vitreous chemerin and vascular endothelial growth factor (VEGF). Methods: This study included 17 patients suffering from PDR and vitreous hemorrhage (VH) (group A), 21 patients with PDR and tractional retinal detachment (TRD) (group B) and 25 patients with idiopathic macular holes or preretinal membranes (control group). All vitreous samples were obtained through pars plana vitrectomy. Enzyme-linked immunosorbent assay and Western blot analysis were performed to evaluate the levels of vitreous chemerin and VEGF. Results: Vitreous concentrations of chemerin were significantly higher in PDR patients with VH and TRD than those in the controls [4.82 ng/ml (3.91-6.13) vs. 5.03 ng/ml (4.01-6.15) vs. 2.53 ng/ml (1.53-5.66), p = 0.025]. The ratio of vitreous chemerin to plasma chemerin concentration significantly differed between groups A and B and the control group [4.93% (4.69-5.34) vs. 4.98% (4.63-5.19) vs. 2.58% (1.78-4.58), p < 0.001]. Western blot results indicated that the levels of vitreous chemerin protein in PDR patients significantly increased compared with those in the controls. Spearman correlation analysis further showed that vitreous chemerin levels in patients with PDR were positively correlated with vitreous VEGF levels (r = -0.542, p < 0.001). Conclusions: Increased vitreous chemerin levels are associated with the development of PDR.

Comparison of Combined and Consecutive Surgery for Patients with Proliferative Diabetic Retinopathy and Severe Cataract

2019 ◽  
Author(s):  
Fei Liu ◽  
Yan Teng ◽  
Yan Shao ◽  
Ximei Chen ◽  
Miao Zhao ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Demographic Data ◽  
Anterior Segment ◽  
Vitreous Hemorrhage ◽  
Panretinal Photocoagulation ◽  
Combined Surgery ◽  
Iol Implantation ◽  
Surgery Group ◽  
Significant Difference

Abstract Objective: To investigate the safety, effectiveness and differences of combined and consecutive surgical strategies on patients with proliferative diabetic retinopathy (PDR) and severe cataract. Methods: Eighty-four cases (84 eyes) with PDR complications of vitreous hemorrhage (VH) and/or tractional retinal detachment (TRD) and severe cataract were enrolled in this retrospective analysis. Thirty-nine eyes in consecutive surgery group underwent the surgery of phacoemulsification (PHACO) and intraocular lens (IOL) implantation firstly, and then received the surgery of vitrectomy, panretinal photocoagulation (PRP) and retinopexy (when necessary) two to twenty-five days later. Forty-five eyes in combined surgery group underwent the combined surgery of PHACO, IOL implantation, vitrectomy, PRP and retinopexy (when necessary). The postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior segment inflammation responses, and surgical complications were chosen as outcome measurements when the two groups were compared. Results: The demographic data of the patients before surgery had no significant difference between the two groups. There was no statistically significant difference on BCVA at postoperative week 6 between two groups (P>0.05). Postoperative inflammation of the anterior segment in combined surgery group was much more serious than that in consecutive surgery group. 91.1% patients (41 eyes) developed moderate or serious inflammation in combined surgery group at postoperative day 3 compared with 46.2% patients (18 eyes) in consecutive surgery group. In addition, there were still 71.1% patients (32 eyes) with mild or moderate inflammation in combined surgery group at postoperative week 6 compared with 28.2% patients (11 eyes) in consecutive surgery group. The IOP elevated in 20 eyes (44.4%) in combined surgery group and seven eyes (17.9%) in consecutive surgery group. The presence of posterior synechia was found in 10 eyes (22.2%) in combined group and one eye (2.6%) in consecutive group 6 weeks after surgery. Conclusion: Although both surgery strategies for PDR patients with severe cataract are safe and effective, combined surgery leads to more postoperative complications than consecutive surgery, which should be carefully monitored and properly treated. For PDR patients with severe cataract which perturbs the vitrectomy and PRP, the consecutive surgery is a priority for surgery choice if the patient's condition allows.

Differences in Levels of Placenta Growth Factor in The Vitreous After Administration of Aflibercept Compared to the Control Group of Proliferative Diabetic Retinopathy

2019 ◽  
Vol 43 (1) ◽  
pp. 105
Author(s):  
Arnila Novitasari Saubig ◽  
Arief Wildan ◽  
Afrisal Hari Kurniawan
Keyword(s):  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Treatment Group ◽  
Proliferative Diabetic Retinopathy ◽  
Hypothesis Test ◽  
Control Group ◽  
Placenta Growth Factor ◽  
Minimum Value ◽  
Maximum Value ◽  
Significant Difference

Introduction: to compare the levels of Placenta Growth Factor in the vitreous on patients with proliferative diabetic retinopathy at Aflibercept administration with control. Method: This is a prospective experimental study with post-test with control design. Subjects were taken from 24 eyes from 24 patients, who came to dr. Kariadi General Hospital and National Diponegoro Hospital between March until September 2016. Subjects were divided into the patient with Aflibercept administration and control. Study variables in this study are Placenta Growth Factor levels in the vitreous in the patient with diabetic proliferative retinopathy. Measurements of PlGF levels with ELISA methods are conducted at GAKI Laboratory, Medical Faculty, Diponegoro University. This data tested for normality used with Saphiro Wilk, and homogeneity variance with Lavene and test hypothesis used with Mann Whitney. Results: Sample of this study are 24 patients proliferative diabetic retinopathy, twelve are the control group, and twelve are Aflibercept group. Average levels of PlGF in the control group are 263,97 pg/ml + 354,98 SD, with minimum value 12,19 pg/ml and maximum value 1002,00 pg/ml. Average levels of PlGF in the treatment group are 92,84 pg/ml + 9,54 SD, with minimum value 76,45 pg/ml and maximum value 112,30 pg/ml. Hypothesis test results obtained significance value 0,488. Conclusion: There was no significant difference between PlGF levels in the control group and the treatment group.

scholarly journals Effect of laser photocoagulation and bevacizumab intravitreal in proliferative diabetic retinopathy: review on biomarkers of oxidative stress

2014 ◽  
Vol 23 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Andi A. Victor ◽  
Tjahjono D. Gondhowiardjo ◽  
Sarwono Waspadji ◽  
Septelia I. Wanandi ◽  
Adang Bachtiar ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Laser Photocoagulation ◽  
Combination Group ◽  
Control Group ◽  
Combined Treatments ◽  
Significant Difference ◽  
Vegf Level ◽  
Biomarkers Of Oxidative Stress

Background: This study was aimed to compare the effect of laser photocoagulation (LF), intravitreal bevacizumab (IVB) and combined treatments on biomarkers of oxidative stress such as aldehhyde dehidrogenase (ALDH), malondialdehyde (MDA) level, superoxide dismutase (SOD) activities, and vitreal vascular endothelial growth factor (VEGF) on proliferative diabetic retinopathy (DR) patients.Methods: In this single blind randomized clinical trial, 72 eyes from 69 cases of proliferative DR in Cipto Mangunkusumo Hospital between February 2011 - June 2013 were randomized into 4 groups : 1) control (n = 18); 2) LF pre-vitrectomy (n = 18); 3) IVB pre-vitrectomy (n = 18); and 4) combined IVB and LF pre-vitrectomy (n = 18). One-way ANOVA was used to compare oxidative stress parameters in the four groups.Results: There were no statistically significant differences in the average plasma ALDH activity (0.034 ± 0.02; 0.027 ± 0.02; 0.025 ± 0.02; 0.031 ± 0.11 IU/mg protein; p = 0.66), vitreal MDA level (1.661 ± 1.21; 1.557 ± 1.32; 1.717 ± 1.54; 1.501 ± 1.09 nmol/mL; p = 0.96) and SOD activity) (0.403 ± 0.50; 0.210 ± 0.18; 0.399 ± 0.49; 0.273 ± 0.32 U/mL; p = 0.38) among these four groups, respectively. However, the VEGF vitreal level (pg/mL) showed a statistically significant difference (0.356 ± 0.60; 0.393 ± 0.45; 0.150 ± 0.24; 0.069 ± 0.13; p = 0.05). The VEGF level in combination group was five times lower than the control group (p = 0.05).Conclusion: Combined treatments of DR by IVB and LF were correlated with lower vitreal MDA and plasma VEGF level, but did not have any effect on plasma ALDH and vitreal SOD in proliferative DR. Combined treatments with IVB and LF are recommended for the management of proliferative DR patients.  

scholarly journals Reduced Expression of Erythropoietin After Intravitreal Ranibizumab in Proliferative Diabetic Retinopathy Patients—Retrospective Interventional Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Li Chen ◽  
Jing Feng ◽  
Yanhong Shi ◽  
Fuxiao Luan ◽  
Fang Ma ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Diagnostic Value ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Diabetic Patients ◽  
Intravitreal Ranibizumab ◽  
Epiretinal Membranes ◽  
Significant Difference ◽  
Endothelial Growth Factor

Purpose: To evaluate the expressions of erythropoietin (EPO) and vascular endothelial growth factor (VEGF) in the vitreous and fibrovascular membranes (FVMs) of proliferative diabetic retinopathy (PDR) after the intravitreal injection of ranibizumab (IVR) and further explore the relationship between EPO and VEGF.Method: The concentrations of EPO and VEGF levels in the vitreous fluid were measured in 35 patients (24 PDR and 11 non-diabetic patients) using enzyme-linked immunosorbent assay. The patients were divided into three groups: PDR with IVR (IVR group) before par plana vitrectomy (n = 10), PDR without IVR (Non-IVR group) (n = 14) and a control group [macular holes (MHs) or epiretinal membranes (ERM), n = 11]. Fluorescence immunostaining was performed to examine the expressions of VEGF, EPO and CD 105 in the excised epiretinal membranes.Result: The PDR eyes of Non-IVR group had the highest vitreous VEGF and EPO levels (836.30 ± 899.50 pg/ml, 99.29 ± 27.77 mIU/ml, respectively) compared to the control group (10.98 ± 0.98 pg/ml and 18.96 ± 13.30 mIU/ml/ml). Both the VEGF and EPO levels in the IVR group (13.22 ± 2.72 pg/ml and 68.57 ± 41.47 mIU/ml) were significantly lower than the Non-IVR group (P = 0.004 and P = 0.04, respectively). Furthermore, no significant difference was observed for VEGF levels between the control and IVR groups (10.9 ± 0.98 pg/ml and 13.22 ± 2.72 pg/ml, respectively, P = 0.9). Yet the EPO level in the IVR group was significantly higher than that in the Non-diabetic group (68.57 ± 41.47 pg/ml and 18.96 ± 13.30 pg/ml, respectively, P = 0.001). The expressions of EPO, VEGF, and CD105 were significantly reduced in fluorescence immunostaining of FVMs in the IVR group compared with the Non-IVR group. The receiver operating characteristic (ROC) curve of the EPO and VEGF levels were 0.951 and 0.938 in the PDR group.Conclusion: Both of the VEGF and EPO level were significantly increased in PDR patients, which have equal diagnostic value in the prediction of PDR. IVR could reduce the EPO level, but not enough to the normal level.

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