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Sanjeewa Wickremasinghe, Sivashanth Gnanasekaran, Esther Bandala-Sanchez, Maria Kolic, Sophie Rogers, Annie McAuley, Sukhpal Singh Sandhu, Lyndell L Lim; The Influence of Intravitreal Ranibizumab on Aqueous Cytokine Concentrations in Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4839. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of intravitreal ranibizumab injections on aqueous concentrations of angiogenic or inflammatory cytokines in patients with diabetic macular edema (DME).
Thirty eyes of 25 patients with center-involved DME were recruited to the study. All had a central macular thickness (CMT) of >300 microns and best corrected visual acuity (BCVA) between 17 to 70 logMAR letters. At baseline, all eyes had 0.1ml of aqueous collected prior to ranibizumab treatment. At Week 4, a second ranibizumab injection was administered and at Week 8, aqueous sampling was repeated prior to a third ranibizumab injection. From Week 12, all eyes were followed at 4-weekly intervals and the need for ranibizumab treatment was determined by BCVA and CMT measurements. Levels of 32 cytokines were assessed at baseline and at Week 8 using a multiplex array assay.
Following two consecutive ranibizumab injections, there was a statistically significant reduction in vascular endothelial growth factor (VEGF) (p=0), as well as IL-1β (p=0.00006), IL-7 (p=0.00002), IL-8 (p=0.00023), IL-10 (p<0.00001), IL-12 (p<0.00001), IL-17 (p=0.00024), MCP-1 (p=0.00023), and TNF-a (p<0.00001). There was also an upregulation of soluble VEGF receptor-2 (sVEGFR-2) (p=0.00004). A P-value of <0.0015 was considered significant in this study.
Ranibizumab treatment influences various inflammatory cytokine concentrations in addition to reducing aqueous VEGF concentrations in patients with DME. This may contribute to its therapeutic effect in patients with DME.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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