Abstract
Purpose: :
Advanced glycation end products (AGEs) are detected in the target organs of diabetic complications and aging processes. In addition, deposition of AGEs gives rise to tissue damage leading to diabetic complications and aging processes. In order to reveal the role of AGEs in diabetic retinopathy or aging process of the eye, the concentration of pyrraline and 3–deoxyglucosone–imidazolone (imidazolone), which are major components of AGEs, was measured in the vitreous fluid collected during vitrectomy in diabetic and non–diabetic patients.
Methods: :
Subjects were 137 eyes of 110 patients (age 59.5 ± 13.9 years, mean ± SD) undergoing primary vitrectomy; 78 eyes with diabetic retinopathy (DM group; 47 eyes with proliferative diabetic retinopathy, 15 eyes with vitreous hemorrhage, 13 eyes with macular edema, and 3 eyes with rubeotic glaucoma) and 59 eyes with non–diabetic ocular diseases (non–DM group; 17 eyes with rhegmatogenous retinal detachment, 13 eyes with macular hole, 10 eyes with proliferative vitreoretinopathy, 7 eyes with vitreous hemorrhage, and 12 eyes with other diseases). Vitreous fluid samples were obtained at the time of vitrectomy, and the level of imidazolone and pyrraline was measured by enzyme–linked immuneosorbent assay.
Results: :
The vitreous imidazolone level in the DM group was significantly higher than that in the non–DM group (0.124±0.035 vs. 0.081±0.019 ; Abs 492nm, p <0.0001). The vitreous pyrraline level was also significantly higher in the DM group than in the non–DM group(0.118±0.033 vs. 0.089±0.022 ; Abs 492nm, p <0.0001). In the DM group, the vitreous imidazolone and pyrraline level in patients with macular edema was significantly higher than those in patients with proliferative diabetic retinopathy (p <0.05) and vitreous hemorrhage (p <0.05). There was strongly positive correlation between the vitreous imidazolone level and vitreous pyrraline level in all subjects (Pearson r=0.935, p<0.0001). There was no correlation between age and vitreous AGEs levels.
Conclusions: :
The vitreous imidazolone and pyrraline level is elevated in diabetic patients. The vitreous AGEs may play a role in the development and progression of diabetic retinopathy.
Keywords: diabetic retinopathy • vitreous • vitreoretinal surgery