Abstract
Purpose:
To evaluate the role Inflammatory cytokines and chemokines in eyes with radiation maculopathy following plaque radiotherapy for uveal melanoma.
Methods:
Vitreous sample were obtained from five patients who developed radiation maculopathy following plaque radiotherapy for uveal melanoma immediately prior intravitreal treatment. Vitreous from five patients undergoing pars plana vitrectomy for macular hole were used as controls. Cytokines were analyzed using a 42 plex-cytokine bead array.
Results:
The clinical manifestations of radiation maculopathy varied among patients. Two patients had macular edema without nerve fiber layer infarcts or retinal dot-blot hemorrhages, two patients had macular edema, nerve fiber layer infarcts and retinal dot-blot hemorrhages and one patient had nerve fiber layer infarcts and retinal dot-blot hemorrhages without significant macular edema. In all patients with radiation maculopathy, fractalkine, GRO, MDC, PDGF-AA, IL-6, IL-8, IP-10, MCP-1 and VGEF were increased in comparison to the controls. Patients with macular edema but without nerve fiber layer infarcts or retinal dot-blot hemorrhages were noted to have RANTES, MDC, sCD40L, IL-15 and Flt-3L increased in comparison to controls. In the patient with nerve fiber layer infarcts and retinal dot-blot hemorrhages without significant macular edema, IFN-a2, GRO, PDGF-AA, IL-6, IL-8 and MCP-1 were increased in comparison to controls and the other 4 patients. Interestingly, VEGF was highest in the patient who had nerve fiber layer infarcts and retinal dot-blot hemorrhages without significant macular edema, while it was lowest in the patients who had macular edema without nerve fiber layer infarcts or retinal dot-blot hemorrhages.
Conclusions:
These study shows that it is safe and feasible to study vitreous cytokines and chemokines from vitreous samples obtained in the clinical setting. Cytokines and chemokines expression pattern seems to be different in various manifestations of radiation maculopathy. With sufficient sample size and power, future studies may help to identify biomarkers predictive of treatment response and identify novel treatment targets in radiation maculopathy.
Keywords: 671 radiation therapy •
589 melanoma •
490 cytokines/chemokines