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Marcel S. Pfister, Michael Koss, Pankaj Singh, Svenja Deuchler, Hanns Ackermann, Frank Koch; Quantitative Determination And Compression Of Intravitreal Cytokines In Drp, Rvo And Armd. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3795.
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© ARVO (1962-2015); The Authors (2016-present)
To determine and compare inflammatory and angiogenetic cytokine levels from undiluted vitreous of patients with diabetic retinopathy (DRP), retinal vein occlusion (RVO) and age-related macular degeneration.
162 patients (median age 67.5 years, 101 male) underwent an intravitreal combination therapy, including a single-site 23-gauge core vitrectomy and the application of bevacizumab, dexamethasone and triamcinolone in RVO (n=80) and DRP (n=70), or bevacizumab, dexamethasone and SF-6-gas in ARMD (n=14). To describe the inflammatory processes we analysed Interleukin-6 (IL-6)- and monocyte chemo attractant protein-1 (MCP-1), for angiogenetic activity we determined intravitreal vascular endothelial growth factor (VEGF-A) levels. Vitreous samples from patients with vitreous floaters served as controls (n = 25).
All patients (n=70) with DRP: IL-6 mean 45.1 + 111.23 pg/ml; MCP-1 517.9 ± 329.5;VEGF-A 351.8 + 545. DRP with cystoid ME (n=48): IL-6 mean 42.3 + 121.1, MCP-1 482.3 ± 348.3, VEGF 236.2 + 368.8. IL-6 diffuse ME (n=22) 51.21 + 88.2pg/ml, MCP-1 595.3 + 275.8,VEGF 604.0 + 759.6.Cystoid vs. diffuse Edema:IL-6 (p=0.29), MCP-1 (<0.05), VEGF (<0,05); Non ischemic DRP (n=37) IL-6: 27.91 + 37.6pg/ml; MCP-1 213.9 + 415.2, VEGF 506.3 + 633.7;Ischemic DRP (n=33) IL-6 64.4 + 156.1 Ischemic vs. non ischemic DRP:IL-6 (p=0,42), VEGF-A (p<0.005); MCP-1 (p=0.84) RVO total: IL-6 (n=80) IL-6 49.4 + 95.5;VEGF-A 325.7; 233.4 + 414.1;MCP-1 845.2 + 779.5.BRVO (n=34) IL-6 24.4 + 54.3; VEGF 170.6 + 337.9,MCP-1 619.2 + 533.0; CRVO (n=46)IL-6: 67.9 + 114.1;VEGF 279.8 + 460.5,MCP-1 1012.3 + 889.6;BRVO vs. CRVO:IL-6(p=0.008),VEGF(p<0.05),MCP-1(p<0.005);ARMD total:IL-6 31.42 + 46.8,MCP-1 1199.7 + 1424.0,VEGF 9.2500 + 17.4.
We found the highest mean IL-6 levels in RVO, highest mean MCP-1 in ARMD, highest mean VEGF in DRP. All Cytokine levels were significantly higher compared to the control group, except VEGF in ARMD.MCP-1 and VEGF were significantly higher in DRP patients with diffuse macular edema compared to cystoid macular edema. When comparing ischemic and non-ischemic DRP only VEGF-A levels were significantly higher. Our findings suggest that the type of macular edema has a higher predictive value on the inflammatory activity than the degree of retinal ischemia. Our results show important differences in intravitreal cytokine levels and suggest that future intravitreal drug application should be more specific to the disease and its stadium.
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