Abstract
Purpose:
The biochemical pathways that drive Diabetic Macular Edema (DME) are only partially understood. Early research into intra-vitreal injection of immunomodulators targeting TNFα has yielded a reduction of macular edema. We therefore examined the correlation between vitreous levels of TNFα and its receptor to severity of DME.<br />
Methods:
In-office vitreous aspirates (50-100 μL) were obtained from 20 eyes of 16 patients undergoing treatment for DME with Anti-VEGF agents during the period between 11/26/08 and 11/24/09 during an IRB approved study. Each vitreous sample was acquired immediately prior to intra-vitreal injection. All vitreous samples were investigated utilizing Reverse Phase Protein Microarray (RPPM) technology. Spectral Domain-OCT was conducted preceding treatment and maximum macular thickness (MMT), central macular thickness (CMT), and total volume (TV) were measured. Correlation between vitreous levels of TNFα and its receptor with severity of DME was determined using Pearson‘s Analysis. <br />
Results:
Thirty-one samples obtained from 20 eyes of 16 patients were studied. Pearson’ coefficients showed no significant correlation between TNFα and MMT, CMT, or TV. However, of the 31 samples,11 were also evaluated for TNFαR. TNFαR was found to have correlation coefficients -0.5248 with TV but no significant correlation with MMT and CMT.<br />
Conclusions:
In-office vitreous sampling reveals an inverse relationship between TNFαR and TV as a measure of severity of DME. Further studies are needed to evaluate the role of immunomodulation in the treatment of treatment of DME.<br />