Jeat, Ang Wen
(2018)
Evaluation of vascular endothelial growth factor level in tear and serum among diabetic patients.
Masters thesis, 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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