Influence of vitreous factors after vitrectomy for macular edema in patients with central retinal vein occlusion

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To investigate whether vitreous fluid levels of vascular endothelial growth factor (VEGF), pigment epithelium-derived factor (PEDF), and soluble intercellular adhesion molecule 1 (sICAM-1) influence visual prognosis and macular edema in patients with central retinal vein occlusion (CRVO). A prospective observational study was performed in 31 consecutive CRVO patients (31 eyes) with macular edema who underwent vitrectomy. Best-corrected visual acuity (BCVA), retinal thickness (examined by OCT), and vitreous fluid levels of VEGF, PEDF, and sICAM-1 were determined. Patients were followed for at least 6 months after surgery. Both visual acuity and retinal thickness showed significant improvement at 6 months postoperatively (P = 0.012 and P  0.001, respectively). Vitreous fluid levels of VEGF were significantly higher (P = 0.027) in patients who showed less improvement of BCVA after vitrectomy than in those with a better outcome. Conversely, vitreous levels of PEDF were significantly lower (P = 0.047) in patients with less improvement of BCVA than in those with a better outcome. Vitreous levels of sICAM-1 were not significantly correlated with BCVA after vitrectomy (P = 0.731). Multiple regression analysis demonstrated that vitreous fluid levels of VEGF and PEDF were significant determinants of the improvement of BCVA (P = 0.013 and P = 0.007, respectively). These results suggest that vitreous fluid levels of VEGF and PEDF might influence visual prognosis after vitrectomy in CRVO patients with macular edema.

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