PURPOSE: The aim of this study was to investigate whether there is any association between the levels of the angiogenic growth factors and the vascular oxygen saturation in eyes with diabetic retinopathy. METHODS: The study was designed as a prospective trial. The cohort consisted of 29 diabetic patients with scheduled vitreous procedures (intravitreal injection or pars plana vitrectomy). The control group included 30 patients scheduled for macular surgery (macular hole or epiretinal membrane). Nine patients (four from the diabetic maculopathy [DM] group and five from the control group) were excluded from the study because of unsuccessful vitreous samples. Retinal oximetry was performed several hours before the vitreous procedure was performed, and vitreous samples were obtained during the procedure. The concentrations of VEGF, Serpin F1/pigment epithelium-derived factor (PEDF), and placental growth factor (PlGF) were measured by ELISA. RESULTS: A negative correlation between level of VEGF and arteriovenous (AV) saturation difference was determined in the DM group (Pearson correlation coefficient r = -0.607; two-tailed test, P = 0.002). Also a negative correlation between level of PlGF and AV saturation difference was determined in the DM group (Pearson correlation coefficient r = -0.521; two-tailed test, P = 0.011) A positive correlation between PlGF level and the vein saturation was not statistically significant (Pearson correlation coefficient r = 0.325; two-tailed test, P = 0.130). We did not find any correlation between vitreous level of PEDF and vascular saturation within the DM group. CONCLUSIONS: Our findings in diabetic patients suggests a correlation between the intravitreal level of proangiogenic factors and the AV difference measured by retinal oximetry.

Department of Ophthalmology Faculty of Medicine Masaryk University Brno Czech Republic

Department of Ophthalmology Military University Hospital Prague 1 st Faculty of Medicine Charles University Prague Czech Republic

Department of Ophthalmology University Hospital Brno Czech Republic

Department of Ophthalmology University Hospital Olomouc Faculty of Medicine and Dentistry Palacký University Olomouc Olomouc Czech Republic

Institute of Medical Biochemistry and Laboratory Diagnostics 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Zobrazit více v PubMed

Hammer M, Vilser W, Riemer T, et al. .. Diabetic patients with retinopathy show increased retinal venous oxygen saturation. Graefes Arch Clin Exp Ophthalmol. 2009; 247: 1025–1030. PubMed

Hardarson SH, Stefánsson E.. Retinal oxygen saturation is altered in diabetic retinopathy. Br J Ophthalmol. 2012; 96: 560–563. PubMed

Khoobehi B, Firn K, Thompson H, Reinoso M, Beach J.. Retinal arterial and venous oxygen saturation is altered in diabetic patients. Invest Ophthalmol Vis Sci. 2013; 54: 7103. PubMed

Jørgensen CM, Hardarson SH, Bek T.. The oxygen saturation in retinal vessels from diabetic patients depends on the severity and type of vision-threatening retinopathy. Acta Ophthalmol (Copenh). 2014; 92: 34–39. PubMed

Šínová I, Chrapek O, Mlčák P, Řehák J, Karhanová M, Šín M. Automatic retinal oxymetry in patients with diabetic retinopathy. Czech Slovak Ophthalmol. 2016; 72: 182–186. PubMed

Veiby NCBB, Simeunovic A, Heier M, et al. .. Venular oxygen saturation is increased in young patients with type 1 diabetes and mild nonproliferative diabetic retinopathy. Acta Ophthalmol (Copenh). 2020; 98: 800–807. PubMed

Guduru A, Martz TG, Waters A, Kshirsagar AV, Garg S.. Oxygen saturation of retinal vessels in all stages of diabetic retinopathy and correlation to ultra-wide field fluorescein angiography. Invest Ophthalmol Vis Sci. 2016; 57: 5278. PubMed

Šínová I, Řehák J, Nekolová J, et al. .. Correlation between ischemic index of retinal vein occlusion and oxygen saturation in retinal vessels. Am J Ophthalmol. 2018; 188: 74–80. PubMed

Kennedy A, Frank RN.. The influence of glucose concentration and hypoxia on VEGF secretion by cultured retinal cells. Curr Eye Res. 2011; 36: 168–177. PubMed

Geirsdottir A, Palsson O, Hardarson SH, Olafsdottir OB, Kristjansdottir JV, Stefánsson E.. Retinal vessel oxygen saturation in healthy individuals. Invest Ophthalmol Vis Sci. 2012; 53: 5433. PubMed

Blondal R, Sturludottir MK, Hardarson SH, Halldorsson GH, Stefánsson E.. Reliability of vessel diameter measurements with a retinal oximeter. Graefes Arch Clin Exp Ophthalmol. 2011; 249: 1311–1317. PubMed

Hardarson SH, Harris A, Karlsson RA, et al. .. Automatic retinal oximetry. Invest Ophthalmol Vis Sci. 2006; 47: 5011. PubMed

Hardarson SH, Basit S, Jonsdottir TE, et al. .. Oxygen saturation in human retinal vessels is higher in dark than in light. Invest Ophthalmol Vis Sci. 2009; 50: 2308. PubMed

Jeppesen SK, Bek T.. The retinal oxygen saturation measured by dual wavelength oximetry in larger retinal vessels is influenced by the linear velocity of the blood. Curr Eye Res. 2019; 44: 46–52. PubMed

Yu Y, Zhang J, Zhu R, et al. .. The profile of angiogenic factors in vitreous humor of the patients with proliferative diabetic retinopathy. Curr Mol Med. 2017; 17: 280–286. PubMed

Mohan N, Monickaraj F, Balasubramanyam M, Rema M, Mohan V.. Imbalanced levels of angiogenic and angiostatic factors in vitreous, plasma and postmortem retinal tissue of patients with proliferative diabetic retinopathy. J Diabetes Complications. 201; 26: 435–441. PubMed

Boehm BO, Lang G, Feldmann B, et al. .. Proliferative diabetic retinopathy is associated with a low level of the natural ocular anti-angiogenic agent pigment epithelium-derived factor (PEDF) in aqueous humor. A pilot study. Horm Metab Res. 2003; 35: 382–386. PubMed

Yokoi M, Yamagishi SI, Saito A, et al. .. Positive association of pigment epithelium-derived factor with total antioxidant capacity in the vitreous fluid of patients with proliferative diabetic retinopathy. Br J Ophthalmol. 2007; 91: 885–887. PubMed PMC

Chernykh V, Varvarinsky E, Smirnov E, Chernykh D, Trunov A.. Proliferative and inflammatory factors in the vitreous of patients with proliferative diabetic retinopathy. Indian J Ophthalmol. 2015; 63: 33. PubMed PMC

Jeong A, Yao X, Van Hemert J, Sagong M.. Clinical significance of metabolic quantification for retinal nonperfusion in diabetic retinopathy. Sci Rep. 2022; 12: 9342. PubMed PMC

Wu F, Phone A, Lamy R, et al. .. Correlation of aqueous, vitreous, and plasma cytokine levels in patients with proliferative diabetic retinopathy. Invest Ophthalmol Vis Sci. 2020; 61(2): 26. PubMed PMC

Wang Y, Liu X, Quan X, et al. .. Pigment epithelium-derived factor and its role in microvascular-related diseases. Biochimie. 2022; 200: 153–171. PubMed

Vergmann AS, Torp TL, Kawasaki R, et al. .. Retinal vascular oxygen saturation in response to a less extensive laser treatment in proliferative diabetic retinopathy. Acta Ophthalmol (Copenh). 2021; 99: 783–789. PubMed