Bevacizumab and triamcinolone acetonide intravitreal effect on Transforming Growth Factor Beta (TGF-β) and Plasminogen Activator Inhibitor-1 (PAI-1) expression in open globe injury model

Introduction: Triamcinolone acetonide (TA) and bevacizumab have anti-inflammation and anti-proliferation in the wound-healing process caused by ocular injury. There was no medicament to treat ocular injury besides corticosteroids and anti-VEGF, but their comparison is not yet elucidated. This study aimed to compare the effects of injection of intravitreal triamcinolone acetonide and bevacizumab in an expression of TGF-β and PAI-1 in an experimental rabbit model of open-globe injury (OGI). TGF beta and PAI-1 have an important role in the hemostasis of the wound healing process, wherein the eye, the wound healing process should not occur excessively because it can cause PVR (unlike wound healing in the skin or other organs in the body). Methods: This study was an experimental study of 30 eye rabbits with an OGI model. Six eyes as control and 24 eyes received treatment for 21 days. Thirty Male New Zealand rabbits and we make OGI in the superotemporal quadrant of the right eyes by making a 5 mm circumferential incision, 6 mm behind the limbus. TA and bevacizumab were treated in different groups. The subjects were divided into several groups: A) OGI group (PC), (B) OGI with intravitreal TA group 3 days after (T3), (C) OGI with intravitreal TA group 7 days after (T7), (D) OGI with intravitreal bevacizumab group 3 days after (B3), and (E) OGI with intravitreal bevacizumab group 7 days after (B7). A negative control group (NC) was randomly selected, including five left eyes from the treatment group (n = 6 each). All eyes were examined and evaluated by measuring the expression level of TGF-β and PAI-1. Normality test was done using Shapiro-Wilk, and the expression was compared using One-way ANOVA and Tukey post-hoc test. Results: The expression of PAI-1 was significantly lower in the treatment group than in the control group (PC) (PC = 10,08 ± 1,23 %, p-value 0,0444). However, the expression of TGF-β was higher in the treatment group compared to the control group (PC) (PC = 6,60 ± 3,30 %, p-value 0,0228). Conclusion: Triamcinolone acetonide and bevacizumab treatments after OGI significantly weakened the upregulation of PAI-1 but could not reduce TGF-β expression in the retina and wound site tissue. It reduces the risk of developing posttraumatic complications of proliferative vitreoretinopathy (PVR).