Vascular endothelial growth factor in the fluid of the anterior chamber of the eye in patients with diabetic retinopathy, cataract and neovascular glaucoma

Aim. To study the role of vascular endothelial growth factor (VEGF-A) in the fluid of the anterior chamber of the eye (ACE) in the evolvement of diabetic retinopathy (DR) and the outcome of cataract surgery. Materials and methods. The study included 120 patients with diabetes mellitus (DM) operated for the removal of cataract. 16 patients received treatment for DR-related neovascular glaucoma (NG). The control group comprised 22 subjects without DM. VEGF-A and glucose levels were measured in the ACE fluid prior to surgery. Results. Patients with DM were not significantly different in terms of VEGF-A, fasting glucose, and HbA1c levels on the day of surgery excepting DM patients without DR. VEGF-A and glucose levels in AEG increased in proportion to DR severity. VEGF-A concentration was minimal in the absence of DR (22.75 pg/ml [10.78; 63.36]) and amounted to 336.6 pg/ml [232.3; 410.74] in patients with DM and DR (P<0.0001). In DM combined with NG the VEGF-A level increased to 1634.01 pg/ml [610.69; 2657.33] (17 times the level in control subjects). Visual acuity in the late postoperative period gradually decreased to the preoperative values 12 months after surgery for severe DR. Thereafter, 7.6% of the patients developed NG. 40% of the patients were treated by retinal laser coagulation; postoperative complications were absent only in 52.4% of the cases. Conclusion. High VEGF-A level in the ACE fluid (above 137.4 pg/ml) greatly contributes to the development of NG after removal of cataract and increases 9.62-12.3 times the risk of NG.