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M. A. Zapata, A. R. Carvalho, I. Figueras, A. Salas, A. Fonollosa, C. Macia, A. Boixadera, J. Garcia-Arumi; Profile of Cytokines and Pro-Inflammatory Mediators in Aqueous Humor and Plasma of Patients With High Risk of Progression Age-Related Maculopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5902.
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To evaluate the profile of cytokines and pro-inflammatory mediators in aqueous humor and plasma of patients with high risk of progression age-related maculopathy. Compare data with patients with exudative age-related macular degeneration and controls.
Aqueous humor and blood samples were collected from 15 eyes with high risk of progression age-related maculopathy and 12 controls during cataract surgery, and in 15 naïve patients with exudative age-related macular degeneration samples were collected before the first intravitreal injection of ranibizumab.High risk of progression maculopathy was define as the presence of at least 1 large druse (diameter greater than or equal to that of a large vein at the disc margin) and the presence of foveal pigment abnormality in both eyes, without advanced AMD. Patients with other inflammatory diseases and anti-inflammatory medication were excluded.Cytokines were measured by an immunoassay using Milliplex Map (Millipore®). We studied IFN-γ, TNF-α, IL1, IL2, IL6, IL8, IL12, and VEGF.Clinical study was completed with fundus photograph, optic coherence tomography and fluoresceine angiography before and after the surgery.We used SPSS v15 for statistical analysis. Mann-Whitney test was performed for the Between-Group comparison. Ethics approval committee was obtained and all patients signed informed consent
Plasma levels of VEGF were higher in patients with exudative AMD and with high risk maculopathy than in controls ( eAMD 414 pg/ml vs Control 114.36 pg/ml; p=0.037) (HRmaculopathy 456.05 pg/ml vs Control 114.36 pg/ml; p=0.032). There were no differences between groups in other mediators in plasma. There were no differences in aqueous profile of mediators between controls and high risk maculopathy. Aqueous levels of VEGF was lower in patients with exudative AMD than in controls (eAMD 53.20 pg/ml vs Controls 176.77 pg/ml; p=0.04). Aqueous levels of IL6 was also lower in patients with exudative AMD than in controls (eAMD 33.53 pg/ml vs Controls 947.39 pg/ml ; p<0.001).
High risk of progression age-related maculopathy may be a pre-neovascular stage and we can find higher plasma levels of VEGF. We have found differences between aqueous and plasma levels of mediators. Aqueous levels may not represent the vitreous or retinal profile of mediators attending the lower aqueous levels of VEGF we have obtained in exudative AMD
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