Effect of laser photocoagulation and bevacizumab intravitreal in proliferative diabetic retinopathy: review on biomarkers of oxidative stress

Andi A. Victor, Tjahjono D. Gondhowiardjo, Sarwono Waspadji, Septelia I. Wanandi, Adang Bachtiar, Franciscus D. Suyatna, Habibah Muhiddin



DOI: https://doi.org/10.13181/mji.v23i2.756

Abstract


Background: This study was aimed to compare the effect of laser photocoagulation (LF), intravitreal bevacizumab (IVB) and combined treatments on biomarkers of oxidative stress such as aldehhyde dehidrogenase (ALDH), malondialdehyde (MDA) level, superoxide dismutase (SOD) activities, and vitreal vascular endothelial growth factor (VEGF) on proliferative diabetic retinopathy (DR) patients.

Methods: In this single blind randomized clinical trial, 72 eyes from 69 cases of proliferative DR in Cipto Mangunkusumo Hospital between February 2011 - June 2013 were randomized into 4 groups : 1) control (n = 18); 2) LF pre-vitrectomy (n = 18); 3) IVB pre-vitrectomy (n = 18); and 4) combined IVB and LF pre-vitrectomy (n = 18). One-way ANOVA was used to compare oxidative stress parameters in the four groups.

Results: There were no statistically significant differences in the average plasma ALDH activity (0.034 ± 0.02; 0.027 ± 0.02; 0.025 ± 0.02; 0.031 ± 0.11 IU/mg protein; p = 0.66), vitreal MDA level (1.661 ± 1.21; 1.557 ± 1.32; 1.717 ± 1.54; 1.501 ± 1.09 nmol/mL; p = 0.96) and SOD activity) (0.403 ± 0.50; 0.210 ± 0.18; 0.399 ± 0.49; 0.273 ± 0.32 U/mL; p = 0.38) among these four groups, respectively. However, the VEGF vitreal level (pg/mL) showed a statistically significant difference (0.356 ± 0.60; 0.393 ± 0.45; 0.150 ± 0.24; 0.069 ± 0.13; p = 0.05). The VEGF level in combination group was five times lower than the control group (p = 0.05).

Conclusion: Combined treatments of DR by IVB and LF were correlated with lower vitreal MDA and plasma VEGF level, but did not have any effect on plasma ALDH and vitreal SOD in proliferative DR. Combined treatments with IVB and LF are recommended for the management of proliferative DR patients.  


Keywords


bevacizumab; diabetic retinopathy; laser photocoagulation; oxidative stress

Full Text:

PDF

References


  1. Chew EY, Ferris III FL. Nonproliferative diabetic retinopathy. In: Ryan SJ, editor. Retina. 5th ed. St. Louis: Mosby; 2006. p.1271-84. http://dx.doi.org/10.1016/B978-0-323-02598-0.50073-2
  2. Frank RN. Etiologic mechanism in diabetic retinopathy. In: Ryan SJ, editor. Retina. 5th ed. St. Louis: Mosby; 2006. p.1241-70. http://dx.doi.org/10.1016/B978-0-323-02598-0.50072-0
  3. Vitreoretinal Division. Department of Ophthalmology Faculty of Medicine Universitas Indonesia. (2013). [Prevalence of diabetic retinopathy]. Unpublished raw data.
  4. Kowluru RA, Chan P-S. Oxidative stress and diabetic retinopathy. Exp Diabet Res. 2007;2007:1-12. http://dx.doi.org/10.1155/2007/21976
  5. Pan HZ, Zhang H, Chang D, Li H, Sui H. The change of oxidative stress products in diabetes mellitus and diabetic retinopathy. Br J Ophthalmol. 2008;92(4):548-51. http://dx.doi.org/10.1136/bjo.2007.130542
  6. Atamer Y, Koçyiğit Y, Atamer A, Mete N, Canoruç N, Toprak G. Alterations of erythrocyte and plasma lipid peroxides as well as antioxidant mechanism in patients with type II diabetes mellitus (NIDDM). Tr J Medical Sciences. 1998;28:143-8.
  7. Mancino R, Di Pierro D, Varesi C, Cerulli A, Feraco A, Cedrone C, et al. Lipid peroxidation and total antioxidant capacity in vitreous, aqueous humor, and blood samples from patients with diabetic retinopathy. Mol Vis. 2011;17:1298-304.
  8. Samuel TV, Murthy DSJ, Dattatreya K, Babu PS, Johncy SS. Impaired antioxidant defence mechanism in diabetic retinopathy. JCDR. 2010;4(6):3429-36.
  9. Gondhowiardjo TD. Characterization of Human Corneal Aldehyde Dehydrogenase [dissertation]. Mount Pleasant (MI): The Netherlands Ophthalmic Research Institute; 1992.
  10. Gondhowiardjo TD. The role of enzymatic exploration in ocular diabetics. In: Kadarisman RS, editor. Understanding ocular diabetics. Jakarta: Department of Ophthalmology Faculty of Medicine Universitas Indonesia; 1999. p. 32-40.
  11. Hasibuan H. Aktivitas Enzim ALDH pada Retinopati Diabetik [thesis]. Mount Pleasant (MI): Universitas Indonesia; 1997. Indonesian.
  12. Suyatna FD, Priyanto, Istiantoro J, Sadikin M. Oxidant and antioxidant status of police officer in the city and rural area. Med J Indones. 2004;13(2):77-80. http://dx.doi.org/10.13181/mji.v13i2.132
  13. Oen LH, Utomo H, Suyatna FD, Hanafiah A, Asikin N. Plasma lipid peroxides in coronary heart disease. Int J Clin Pharmacol Ther Toxicol 1992;30(3):77-80.
  14. Wills ED. Mechanisms of lipid peroxide formation in animal tissues. Biochem J. 1966;99(3):667-76.
  15. Randox Laboratories [Internet]. Ransod superoxide dismutase manual. Available from: http://www.randox.com.
  16. Ishizaki E, Takai S, Ueki M, Maeno T, Maruichi M, Sugiyama T, et al. Correlation between angiotensin-converting enzyme, vascular endothelial growth factor, and matrix metalloproteinase-9 in the vitreous of eyes with diabetic retinopathy. Am J Ophthalmol. 2006;141(1):129-34. http://dx.doi.org/10.1016/j.ajo.2005.08.066
  17. Sinawat S, Rattanapakorn T, Sanguansak T, Yospaiboon Y, Sinawat S. Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation. Eye (Lond). 2013;27(12):1391-6. http://dx.doi.org/10.1038/eye.2013.200
  18. Galetović D, Bojić L, Bućan K, Karlica D, Lesin M, Znaor L. The role of oxidative stress after retinal laser photocoagulation in nonproliferative diabetic retinopathy. Coll Antropol. 2011;35(3):835-40.
  19. Lam DS, Lai TY, Lee VY, Chan CK, Liu DT, Mohamed S, et al. Efficacy of 1.25 mg versus 2.5 mg intravitreal bevacizumab for diabetic macular edema. six month results of a randomized controlled trial. Retina. 2009;29(3):292-9. http://dx.doi.org/10.1097/IAE.0b013e31819a2d61
  20. Cho WB, Oh SB, Moon JW, Kim HC. Panretinal photocoagulation combined with intravitreal bavacizumab in high risk proliferative diabetic retinopathy. Retina. 2009;29(4):516-22. http://dx.doi.org/10.1097/IAE.0b013e31819a5fc2
  21. Krohne TU, Eter N, Holz FG, Meyer CH. Intraocular pharmacokinetics of bevacizumab after a single intravitreal injection in humans. Am J Ophthalmol. 2008;146(4):508-12. http://dx.doi.org/10.1016/j.ajo.2008.05.036
  22. Green K, Brand MD, Murphy MP. Prevention of mitochondrial oxidative damage as a therapeutic strategy in diabetes. Diabetes. 2004;53(suppl1):S110-8. http://dx.doi.org/10.2337/diabetes.53.2007.S110
  23. Qian J, Lu Q, Tao Y, Jiang YR. Vitreous and plasma concentrations of apelin and vascular endothelial growth factor after intravitreal bevacizumab in eyes with proliferative diabetic retinopathy. Retina. 2011;31(1):161-8.
  24. Stefánsson E, Novack RL, Hatchell DL. Vitrectomy prevents retinal hypoxia in branch retinal vein occlusion. Invest Ophthalmol Vis Sci. 1990;31(2):284-9.
  25. Durmuş M, Yilmaz HR, Uz E, N Özçelik. The effect of caffeic acid phenethyl ester (CAPE) treatment on levels of MDA, NO, and antioxidant enzymes activities in retinas of streptozotocin-induced diabetic rats. Turk J Med Sci. 2008;38(6):525-30.
  26. Halliwell B, Gutteridge JM. Lipid peroxidation, oxygen radicals, cell damage and antioxidant therapy. Lancet. 1984;1(8391):1396-7. http://dx.doi.org/10.1016/S0140-6736(84)91886-5
  27. Donnely R, Idris I, Forrester JV. Protein kinase C inhibition and diabetic retinopathy: a shot in the dark at translational research. Br J Ophthalmol. 2004; 88(1):145-51. http://dx.doi.org/10.1136/bjo.88.1.145





Copyright (c) 2014 Andi A. Victor, Tjahjono D. Gondhowiardjo, Sarwono Waspadji, Septelia I. Wanandi, Adang Bachtiar, Franciscus D. Suyatna, Habibah Muhiddin

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

All articles and issues in Medical Journal of Indonesia have unique DOI number registered in Crossref.
 
Romeo
 
http://mji.ui.ac.id/journal/index.php/mji/pages/view/stat 
Unique Visitors