Proliferative Diabetic Retinopathy Clinical Trial
Official title:
Vitreous Levels of Cysteine-rich 61 in Patients With Proliferative Diabetic Retinopathy
To determine the vitreous levels of fractalkine, cysteine-rich 61 (Cyr61), and VEGF in patients with PDR. Verifying that it is greater to that found in non-diabetic patients with different non-angiogenetic diseases.
Introduction:
Angiogenesis, the growth and proliferation of new blood vessels, is an important aspect of
the vascular proliferation found in tumor growth, wound repair, inflammatory states, and
ischemic sequel in the ocular angiogenetic diseases. Intraocular neovascularization, the
major eventually complication of diabetic mellitus, may result in vitreous hemorrhage,
tractional retinal detachment, neovascularization glaucoma and eventually blindness. The
involved factors include basic fibroblast growth factor (bFGF), insulin-like growth factor-I
(IGF-I), vascular endothelial cell growth factor (VEGF), and Connective tissue growth factor
(CTGF)/Cysteine-rich protein (Cyr61)/Nephroblastoma overexpressed gene (CCN) family. VEGF is
a primary angiogenic factor that mediates ischemic-induced retinal neovascularization. VEGF
level are elevated in the vitreous fluid in patients with proliferative diabetic retinopathy
(PDR). The unselective anti-VEGF antibody bevacizumab has been used for the treatment of
diabetic retinopathy.
Problem:
In spite of its potent anti-VEGF property, it does not completely inhibit ischemia-induced
retinal neovascularization. Several other factors which were detected to have increased
vitreous levels in the PDR patients might participate in the angiogenic process of diabetic
retinopathy. One of the member of the CCN family, connective tissue growth factor (CTGF),
was found to be involved in the angiogenesis and fibrosis mechanism of PDR. It is unclear if
the other factors in the CCN family might also control the development of retinal
angiogenesis and fibrosis.We measured vitreous cysteine-rich 61 (Cyr61) levels in PDR
patients, non-diabetic patients,and PDR patients pretreated with bevacizumab. We further
correlated the cysteine-rich 61 levels with different stages of PDR. Concomitant VEGF level
was also measured to better understand the interaction of different factors.
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Allocation: Non-Randomized, Intervention Model: Single Group Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Basic Science
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