Evaluation of vascular endothelial growth factor level in tear and serum among diabetic patients
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Date
2018
Authors
Jen, Ang Wen
Journal Title
Journal ISSN
Volume Title
Publisher
Pusat Pengajian Sains Perubatan, Universiti Sains Malaysia
Abstract
Introduction Vascular endothelial growth factor (VEGF) has been postulated to play a role in the pathogenesis and progression of diabetic retinopathy (DR). Thus, detection of VEGF level in ocular tissue may perhaps provide insight into a role of VEGF in pathogenesis of DR. Objective: The objective of this study was to evaluate the VEGF in serum and tears between different type of DR severity among type 2 diabetes mellitus (DM) patients and to determine the correlation between serum and tears VEGF levels. Methods: A comparative cross-sectional study was conducted at a tertiary hospital in Malaysia, Hospital Universiti Sains Malaysia (USM) between August 2016 and May 2018 involving type 2 DM patients with different status of DR [no DR, non-proliferative DR (NPDR), proliferative DR (PDR)]. Tear samples were collected using no.41 Whatman filter paper (Schirmer’s strips) and 5 mls of blood sample were drawn by venous puncture. VEGF levels in tears and serum were measured by enzyme-linked immunosorbent assay. ixResults: A total of 88 type 2 DM patients (no DR: 30 patients, NPDR: 28 patients, PDR: 30 patients) were included into the study. Mean tear VEGF were significantly higher in NPDR and PDR groups (114.9 SD 8.6 pg/mL and 149.5 SD 10.4 pg/mL respectively) as compared to no DR (41.2 SD 11.3 pg/mL, p < 0.001). There was no significant difference of mean serum VEGF between the three groups. There was a fair correlation between serum and tears VEGF (p = 0.015, r = 0.263). Conclusion: Among type 2 DM patients, VEGF levels in tears were higher amongst patients with DR compared to those without DR. Tear VEGF levels were also significantly associated to the severity of DR. There was a fair correlation between serum and tears VEGF. Detection of VEGF in tears is a good non-invasive predictor test for severity of DR. A large cohort study is needed for further evaluation.
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Keywords
Diabetic retinopathy