Department of Ophthalmology, the First Hospital of China Medical University, Shenyang, China.
Department of Ophthalmology, Hainan General Hospital, Haikou, China ; and.
Retina. 2021 Apr 1;41(4):834-843. doi: 10.1097/IAE.0000000000002918.
This study aimed to investigate the effect of intravitreal conbercept (IVC) injections on the aqueous humor concentrations of angiogenic and inflammatory cytokines in patients with macular edema (ME) due to central retinal vein occlusion and to determine whether changes in cytokine levels after IVC are associated with the development of rebound ME.
Forty-nine patients with ME caused by central retinal vein occlusion were included in this retrospective study. Monthly doses of IVC were administered for three months, followed by a Pro Re Nata dosing regimen. Rebound ME was defined as ≥110% increase in the foveal thickness compared with the baseline. Whenever injections were administered, aqueous humor samples were obtained. Multiplex bead assay was used to measure seven angiogenic and inflammatory cytokines in aqueous humor samples.
At baseline, patients with central retinal vein occlusion showed significantly higher aqueous humor concentrations of vascular endothelial growth factor, placental growth factor, monocyte chemoattractant protein-1, platelet-derived growth factor-AA, IL-6, IL-8, and IL-12. At 1-month and 2-month follow-up after IVC, significantly decreased concentrations of all cytokines were observed. During the 12-month follow-up period, 6 of the 49 eyes (12.2%) showed rebound ME after IVC. Patients with rebound ME showed significantly elevated levels of inflammatory but not angiogenic cytokines.
Angiogenic and inflammatory cytokines were overexpressed in patients with ME caused by central retinal vein occlusion. Conbercept treatment influenced the concentrations of various inflammatory cytokines and reduced aqueous vascular endothelial growth factor and placental growth factor concentrations. Rebound ME may occur due to disruption of the balance between angiogenic and inflammatory cytokines and an accompanying excess of inflammatory cytokines but not angiogenic cytokines, after antivascular endothelial growth factor therapy.
本研究旨在探讨玻璃体内注射康柏西普（IVC）对视网膜中央静脉阻塞引起的黄斑水肿（ME）患者房水中血管生成和炎症细胞因子浓度的影响，并确定 IVC 后细胞因子水平的变化是否与反弹 ME 的发生有关。
本回顾性研究纳入了 49 例由视网膜中央静脉阻塞引起的 ME 患者。前三个月每月给予 IVC 剂量，然后采用 Pro Re Nata 给药方案。反弹 ME 定义为与基线相比，中心凹厚度增加≥110%。每次注射时，均采集房水样本。采用多重微球检测法测量房水中 7 种血管生成和炎症细胞因子。
基线时，视网膜中央静脉阻塞患者房水中血管内皮生长因子、胎盘生长因子、单核细胞趋化蛋白-1、血小板衍生生长因子-AA、IL-6、IL-8 和 IL-12 的浓度明显较高。在 IVC 后 1 个月和 2 个月的随访中，观察到所有细胞因子的浓度均显著降低。在 12 个月的随访期间，49 只眼中有 6 只（12.2%）在 IVC 后出现反弹 ME。反弹 ME 患者的炎症细胞因子水平显著升高，但血管生成细胞因子水平没有升高。
视网膜中央静脉阻塞引起的 ME 患者中存在血管生成和炎症细胞因子的过度表达。康柏西普治疗影响了各种炎症细胞因子的浓度，并降低了房水中血管内皮生长因子和胎盘生长因子的浓度。反弹 ME 可能是由于抗血管内皮生长因子治疗后血管生成和炎症细胞因子之间的平衡被破坏，同时伴有炎症细胞因子的过度表达而不是血管生成细胞因子的过度表达所致。
