Vitreoretina Services, Narayana Nethralaya, Bengaluru, India .
Retin Cases Brief Rep. 2021 Mar 1;15(2):127-130. doi: 10.1097/ICB.0000000000000768.
To report an alternative cytokine-based customized therapeutic approach of macular edema secondary to retinal vein occlusion.
A 64-year-old male patient presented with left eye macular edema secondary to central retinal vein occlusion, status after three consecutive anti-vascular endothelial growth factor injections. He was subsequently subjected to aqueous humor cytokine analysis. Vascular endothelial growth factor, interleukin-6 (IL-6), and interleukin-8 (IL-8) concentrations were determined using multiplex bead assay (BD Cytometric Bead Array). Based on the results, intravitreal steroid was administered. Follow-up examination included monitoring corrected distance visual acuity using Snellen's chart, central subfoveal thickness measurement on spectral domain optical coherence tomography (Spectralis, HRA2; Heidelberg engineering, Heidelberg, Germany) and cytokine quantification at the end of one and three months.
Baseline corrected distance visual acuity was counting fingers at 1 m, which subsequently improved to 6/12 Snellen equivalent 1 month after customized intravitreal therapy. Central subfoveal thickness demonstrated significant reduction from 529 to 253 µm; baseline vascular endothelial growth factor, IL-6, and IL-8 concentration were ascertained to be 29.94, 1.31, and 82.12 pg/mL (picograms/millilitre). One month after intravitreal steroid injection, the IL-8 levels normalized to 13.28 pg/mL. Functional and anatomical improvements were sustained till the last follow-up at 3 months.
Customized intravitreal treatment provides an objective, alternative, and effective therapeutic approach for macular edema secondary to retinal vein occlusion.
报告一种基于细胞因子的定制化治疗方法，用于治疗视网膜静脉阻塞引起的黄斑水肿。
一名 64 岁男性患者左眼患有黄斑水肿，继发于视网膜中央静脉阻塞，此前已连续接受了 3 次抗血管内皮生长因子注射治疗。随后对其房水细胞因子进行分析。采用多重微球检测法（BD 流式细胞术微球阵列）测定血管内皮生长因子、白细胞介素-6（IL-6）和白细胞介素-8（IL-8）的浓度。根据结果，给予玻璃体内皮质类固醇治疗。随访检查包括使用 Snellen 图表监测矫正视力距离，使用光谱域光相干断层扫描（Spectralis，HRA2；Heidelberg Engineering，Heidelberg，Germany）测量中心黄斑区视网膜厚度，以及在治疗结束后 1 个月和 3 个月时进行细胞因子定量。
基线矫正视力距离为手动识别 1 米距离，经定制化玻璃体内治疗后 1 个月提高至 6/12 Snellen 等价视力。中心黄斑区视网膜厚度从 529µm 显著减少至 253µm；基线血管内皮生长因子、IL-6 和 IL-8 浓度分别为 29.94pg/mL、1.31pg/mL 和 82.12pg/mL。玻璃体内皮质类固醇注射后 1 个月，IL-8 水平恢复正常至 13.28pg/mL。功能和解剖学改善持续至最后一次 3 个月随访。
定制化玻璃体内治疗为视网膜静脉阻塞引起的黄斑水肿提供了一种客观、替代和有效的治疗方法。
