Purpose
To determine the relationships between the retinal morphological changes and concentrations of intravitreal cytokines in eyes with diabetic macular edema (DME).
Methods
Retrospective comparative study. The preoperative optical coherence tomographic (OCT) images were evaluated to determine the presence of serous retinal detachments (SRDs), retinal cysts, and retinal swelling. The concentrations of VEGF, interleukin (IL)-6, and IL-8 in vitreous samples collected during vitrectomy were determined. The correlations between the OCT parameters and the concentration of the cytokines and other clinical data were calculated. The effects of intravitreal triamcinolone (IVTA) or bevacizumab (IVB) on the SRD was also examined in other eyes.
Results
Fifty-two eyes (52 patients) were investigated. A SRD was found in 36.5% (19/52) of the eyes. Multivariate regression analysis showed that IL-6 was the only factor significantly associated with the presence of a SRD (P=0.001, odds ratio 1.024, 95% confidence interval 1.010-1.038). Retinal cysts were found in 69.2% (36/52) of the eyes, and retinal swelling was found in 75.0% (39/52)of the eyes. The presence of cysts was not significantly associated with the presence of any of the retinal pathologies. Among 24 DME eyes with a SRD, the SRD disappeared significantly more frequently after IVTA (9/12 eyes) than after IVB (2/12 eyes; P=0.012).
Conclusions
The significant association of a SRD with the level of intravitreal IL-6 and its better responsiveness to IVTA indicate that inflammation plays an important role in the development of SRD in DME eyes. SRD may be important in determining the type of treatment for DME.
Keywords: 499 diabetic retinopathy •
490 cytokines/chemokines