Purpose To investigate the roles of vascular endothelial growth factor (VEGF),glutamate and gamma;- aminobutyric acid (GABA) in neovascularization of proliferative diabetic retinopathy (PDR). Methods Vitreous samples were collected from 25 patients (27 eyes)with PDR and 14 patients (14 eyes) with idiopathic macular hole.VEGF levels were determined by ELISA.Amino acids analyses were performed by high-performance liquid chromatography. Results Patients with PDR had significantly higher concentrations of VEGF (median 0.41 ng/ml,quartile 0.54 ng/ml) than controls (median 0.017 ng/ml,quartile 0.01 ng/ml)(Plt;0.001).The levels of glutamate [(11.7plusmn;3.0) mu;mol/L] and GABA [(7.2plusmn;3.9mu;mol/L)] were also higher in patients with PDR than glutamate [(5.8plusmn;0.7) mu;mol/L] and GABA [(3.3plusmn;2.9) mu;mol/L) in controls (Plt;0.05).The glutamate level and GABA level had a significantly positive correlation with VEGF level. Conclusions The increased levels of glutamate and GABA indicate retinal ischemia.The correlations of glutamate and GABA levels with an elevated VEGF level provide biochemical support for ischemi induced neovascularization in patients with PDR.The findings present novel modalities in treatment of PDR. (Chin J Ocul Fundus Dis,2000,16:162-165)