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We measured the concentrations of the complement activation products (C3a, C4a), VEGF, and monocyte chemotactic protein-1 in the aqueous humor during intravitreal anti-VEGF injections for CNV. The VEGF level decreased significantly (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001), while the C3a and C4a levels increased significantly (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001 for both comparisons) 1\u00a0month after two monthly anti-VEGF injections. The VEGF level was correlated with the C3a (R\u2009=\u20090.328,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.007) and C4a (R\u2009=\u2009\u2212\u20090.237,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.055) levels at baseline, but the correlation between the VEGF and C3a levels (R\u2009=\u2009\u2212\u20090.148,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.242) changed significantly (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.028 by analysis of covariance) after anti-VEGF treatment. The C3a increase after anti-VEGF therapy did not change the visual outcomes in eyes with CNV for 1\u00a0year. Dysregulation of the complement system can be induced after anti-VEGF therapy.\n                  <\/jats:p>","DOI":"10.1038\/s41598-021-87340-6","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T06:10:06Z","timestamp":1618812606000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Changes in complement activation products after anti-VEGF injection for choroidal neovascularization in age-related macular degeneration and pachychoroid disease"],"prefix":"10.1038","volume":"11","author":[{"given":"Keiichiro","family":"Tanaka","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuharu","family":"Oguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Omori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumi","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Shintake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryutaro","family":"Tomita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihito","family":"Kasai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Ogasawara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukinori","family":"Sugano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanako","family":"Itagaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Ojima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Machida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideharu","family":"Sekine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuju","family":"Sekiryu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"87340_CR1","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1001\/archopht.122.4.477","volume":"122","author":"N Congdon","year":"2004","unstructured":"Congdon, N. et al. 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