Department of Retina Center, Affiliated Eye Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China.
Chicago College of Optometry, Midwestern University, Downers Grove, IL, USA.
Acta Ophthalmol. 2022 Jun;100(4):e891-e898. doi: 10.1111/aos.15008. Epub 2021 Aug 17.
In eyes with diabetic macular oedema (DME), aqueous humour (AH) cytokine levels before and after anti-vascular endothelial growth factor (VEGF) treatment were compared and correlated with optical coherence tomography structural parameters.
This prospective study included 56 control patients with cataracts and 83 patients with DME manifesting as diffuse retinal thickening (DRT), cystoid macular oedema and serous retinal detachment (SRD). AH samples were obtained before intravitreal injection of anti-VEGF or cataract surgery. VEGF, interleukin (IL)-6, IL-8, IL-10, interferon-inducible protein 10 (IP-10) and monocyte chemotactic protein 1 (MCP-1) levels were measured by multiplex bead assay. AH cytokine levels, central macular thickness (CMT), number of hyper-reflective foci (HF), continuity of external limiting membrane and ellipsoid zone (EZ) and best-corrected visual acuity were evaluated.
In SRD, IL-6 and MCP-1 levels and HF were increased (all p < 0.05) compared to DRT. At baseline, the number of HF was correlated with VEGF, IL-6, IL-8, IP-10 and MCP-1 (all p < 0.05). Eyes sensitive to anti-VEGF treatment had high baseline levels of VEGF, MCP-1, HF and many EZ disruptions (all p < 0.05). DME patients with normal VEGF levels but with high levels of IL-8, IP-10 and MCP-1 (all p < 0.05) had little change in CMT after anti-VEGF treatment (p = 0.678).
AH concentrations of some inflammatory cytokines in DME were differentially expressed among the three DME morphologies. HF was associated with VEGF and other inflammatory cytokine levels. Multiple HF at baseline predicted a significant decrease in CMT, and eyes with normal VEGF but increased inflammatory cytokines may be insensitive to anti-VEGF treatment.
比较糖尿病性黄斑水肿（DME）患者治疗前后房水中细胞因子的水平，并将其与光相干断层扫描（OCT）结构参数相关联。
本前瞻性研究纳入了 56 名白内障对照患者和 83 名 DME 患者，这些患者表现为弥漫性视网膜增厚（DRT）、囊样黄斑水肿和浆液性视网膜脱离（SRD）。在玻璃体内注射抗 VEGF 或白内障手术后采集房水样本。通过多重微珠检测法测定 VEGF、白细胞介素（IL）-6、IL-8、IL-10、干扰素诱导蛋白 10（IP-10）和单核细胞趋化蛋白 1（MCP-1）的水平。评估房水中细胞因子水平、黄斑中心视网膜厚度（CMT）、高反射焦点（HF）数量、外界膜和椭圆体带（EZ）的连续性以及最佳矫正视力。
在 SRD 中，与 DRT 相比，IL-6 和 MCP-1 水平和 HF 增加（均 p<0.05）。在基线时，HF 的数量与 VEGF、IL-6、IL-8、IP-10 和 MCP-1 呈正相关（均 p<0.05）。对抗 VEGF 治疗敏感的眼在基线时具有高 VEGF、MCP-1、HF 和许多 EZ 中断（均 p<0.05）。DME 患者的 VEGF 水平正常，但 IL-8、IP-10 和 MCP-1 水平较高（均 p<0.05），在抗 VEGF 治疗后 CMT 变化不大（p=0.678）。
在三种 DME 形态中，DME 患者房水中一些炎症细胞因子的浓度存在差异表达。HF 与 VEGF 和其他炎症细胞因子水平相关。基线时 HF 数量多预示 CMT 显著下降，而 VEGF 正常但炎症细胞因子升高的眼可能对抗 VEGF 治疗不敏感。
