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Marc Figueras-Roca, Anna Sala-Puigdollers, Socorro Alforja, Elisabeth Blanch, Vanesa Budi, Javier Zarranz-Ventura, Alfredo Adán, Blanca Molins; Aqueous Humour Cytokine Levels May Predict Diabetic Macular Edema Response to Intravitreal Dexamethasone Implant Injection. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4826. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether baseline cytokine aqueous humour (AH) levels are associated with diabetic macular edema (DME) response to dexamethasone intravitreal implant (DEX) injection.
Case series study of 59 adults with diabetes mellitus, centre-involving DME (59 eyes) and central subfield macular thickness (CSMT) >300 μm on spectral domain optical coherence tomography (OCT) receiving DEX treatment. Exclusion criteria was defined on proliferative retinopathy, intravitreal injection of any kind within 6 months and prior ocular surgery beyond uncomplicated cataract removal. Best-corrected visual acuity (Snellen chart), intraocular pressure and OCT exploration (standard Macular Cube 518x128 μm scan on Cirrus, Carl-Zeiss Meditec Inc., Dublin, CA, USA) were carried out prior to treatment and 4-8 weeks afterwards. Anterior chamber tap with AH sampling was performed at DEX injection time. Multiplex immunossay was undertaken for interleukin (IL)-1β, IL-6, IL-8, IL-10, interferon gamma-induced protein (IP)-10, monocyte chemoattractant protein (MCP)-1, tumor necrosis factor (TNF)-α and vascular endothelial growth factor (VEGF). Main outcome measure was set on correlation between baseline AH mediators levels and CSMT and macular volume (MV) change after DEX injection.
Higher IL-6, IL-8, IP-10 and MCP-1 levels correlated to greater decreases in absolut MV (mean -1.46 ± 1.26 mm3): IL-6 (r=-0.352, p=0.006), IL-8 (r=-0.365, p=0.004), IP-10 (r=-0.298, p=0.022) and MCP-1 (r=-0.333, p=0.010). Accordingly, relative MV change (mean -10.96 ± 8.25 %) was also related to IL-6 (r=-0.333, p=0.010), IL-8 (r=-0.361, p=0.005), IP-10 (r=-0.314, p=0.015) and MCP-1 (r=-0.310, p=0.017). In addition, relative CSMT change (mean -27.22 ± 16.83 %) was associated to baseline levels of IP-10 (r=-0.290, p=0.026).
Baseline AH levels of IL-6, IL-8, IP-10 and MCP-1 could be considered predictors of OCT-based DME response to DEX treatment. As a whole, our findings enforce clinical knowledge on DEX action on DME cases and could support future studies on treatment individualization of such a disease.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Statistically signficant correlations between IL-6, IL-8, IP-10 and MCP-1 aqueous humour levels (pg/ml) and OCT-based macular volum (mm3) absolut change (ChMV) due to intravitreal dexamethasone implant injection for DME. Showing drawn line as correlation. Note Y-axis set on logaritmic scale.
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