1. Implication of inflammatory cytokines in the aqueous humour for management of macular diseases.
- Author
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Yi QY, Wang YY, Chen LS, Li WD, Shen Y, Jin Y, Yang J, Wang Y, Yuan J, and Cheng L
- Subjects
- Adult, Aged, Aqueous Humor drug effects, Enzyme-Linked Immunosorbent Assay, Female, Humans, Intercellular Adhesion Molecule-1, Interleukin-6 metabolism, Male, Middle Aged, Tomography, Optical Coherence, Vascular Endothelial Growth Factor A metabolism, Visual Acuity, Aqueous Humor metabolism, Cytokines metabolism, Retinal Diseases drug therapy, Vascular Endothelial Growth Factor A administration & dosage
- Abstract
Purpose: To characterize profile of cytokines in aqueous humour of common macular diseases during intravitreal anti-VEGF therapy., Methods: Aqueous humour from eyes with central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), diabetic macular oedema (DME), neovascular age-related macular degeneration (nAMD) or pathologic myopia associated choroidal neovascularization (pmCNV) was sampled prior to 1st (n = 144) and 2nd (n = 48) intravitreal anti-VEGF therapy. Cytokines including vascular endothelium growth factor (VEGF), intercellular adhesion molecule 1 (ICAM-1) and interleukin 6 (IL-6) were quantitated and analysed along with retinal thickness data by optical coherence tomography (OCT) across two intravitreal injections and five macular disease types., Results: ICAM-1, IL-6 and VEGF are positively associated in the aqueous humour of naive eyes (r = 0.39-0.77, p = 0.018 to <0.0001). ICAM-1, VEGF and IL-6 were significantly higher in CRVO and DME while lowest in pmCNV (p < 0.0001). Reduction of central retinal thickness (CRT) as a favourable response to anti-VEGF therapy was in the order of CRVO, BRVO, DME and nAMD/pmCNV (p < 0.0001). The strongest predictor for favourable CRT reduction was baseline CRT (p < 0.0001) followed by baseline ICAM-1 (p = 0.04). After the 1st intravitreal anti-VEGF therapy, VEGF in aqueous humour lowered significantly but ICAM-1 and IL-6 levels remained unchanged. ICAM-1 was not predictive for CRT reduction following 2nd anti-VEGF therapy., Conclusion: Rate of cytokine production is disease-dependent and higher in CRVO and DME. Anatomical response to intravitreal anti-VEGF therapy is disease-specific and best in RVO patients. A combination therapy using both anti-VEGF and anti-inflammatory therapeutics may be superior to single anti-VEGF therapy, at least for RVO and DME., (© 2019 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
- Published
- 2020
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