増殖糖尿病網膜症の臨床像と硝子体中血管内皮細胞増殖因子

Clinical features of proliferative diabetic retinopathy as related to vitreous level of vascular endothelial growth factor（VEGF）

要約　増殖糖尿病網膜症24眼で，硝子体手術中に採取した硝子体中の血管内皮細胞増殖因子（VEGF）値を検索した。11眼では光凝固の既往がなく，13眼では汎網膜光凝固が行われていた。硝子体VEGF値は，光凝固未施行群では2,707±1,171pg/ml，施行群では903±584pg/mlであり，未施行群では施行群よりも有意に高値であった（p＜0.01）。網膜剝離や増殖膜の有無でVEGF値に差はなかった。未施行群では硝子体出血があるときVEGFが高かったが（p＜0.05），施行群では硝子体出血は関係しなかった。増殖糖尿病網膜症で硝子体VEGF値と関係する臨床像は，網膜上の新生血管と，虹彩または隅角ルベオーシスであると推察された。

Abstract.　We quantitated the intravitreal level of vascular endothelial growth factor（VEGF）in 24 eyes of proliferative diabetic retinopathy from samples obtained during vitrectomy. Out of the 24 eyes,11 had received no photocoagulation prior to surgery and 13 eyes had received panretinal photocoagulation. The intravitreal level of VEGF averaged 2,707±1,171pg/ml in the former group and 903±584pg/ml in the latter. The difference was significant（p＜0.01）. The VEGF level was independent on the presence of retinal detachment or proliferative membrane. It was elevated when vitreous hemorrhage was present in eyes with no past history of photocoatulation（p＜0.05）. It was independent on vitreous hemorrhage in eyes with prior photocoagulation. It seemed likely that the intravitreal level of VEGF was positively correlated with retinal neovascularization and rubeosis of the iris or chamber angle.