Abstract
Purpose:
To evaluate the dynamic change of aqueous concentrations of cytokine and their receptors during the clinical course of ranibizumab treatment in patients with diabetic macular edema (DME). The relationships between clinical parameters and aqueous cytokines were also investigated.
Methods:
Twenty eyes of 20 treatment-naïve DME patients whose central macular thickness (CMT) more than 400 µm were recruited in this study. Three monthly injections of 0.5 mg/0.05ml ranibizumab were performed in each subject, and aqueous humor was collected in each injection. Aqueous concentrations of VEGF, PlGF, IL-6, IL-8, PDGF-AA, IP-10, and VEGF receptor 1 (VEGFR1) and VEGF receptor 2 (VEGFR2) were measured with enzyme linked assay (ELISA). CMT and logMAR visual acuity (VA) were also recorded in each visit.
Results:
During the clinical course of ranibizumab treatment, VEGF, PlGF, IL-6, IL-8 and VEGFR1 were gradually and significantly decreased, in contrast dynamic change of PDGF-AA IP-10 and VEGFR2 were interesting. After the initial 3 injections, CMT in all 20 cases were decreased, while VA were improved (better than 0.2) in 12 of 20 cases, which were significantly correlated with increase of PDGF-AA, IP-10 and VEGFR2. The other 8 cases did not show the increase of these cytokines.
Conclusions:
During the treatment of 3 monthly ranibizumab for DME, aqueous concentrations of cytokines were gradually changed, and improvement of visual function was correlated with increase of PDGF-AA, IP-10 and VEGFR2, suggested that these cytokines may have pivotal roles of functional recovery from morphological regression of DME.