Abstract
Purpose :
Evidence suggests that inflammatory cytokines not only play a role in the pathogenesis of nAMD but also may be useful as biomarkers to predict disease severity and response to treatment. We aimed to quantitatively summarize data on inflammatory cytokines associated with nAMD.
Methods :
A systematic search of peer-reviewed English-language articles without year limitation was performed up to October 14, 2019. Studies were included if they provided data on aqueous or vitreous cytokine concentrations in patients with nAMD. Data were extracted from 89 studies that encompassed 2910 study eyes with nAMD and 1073 control eyes. Effect sizes were generated as standardized mean differences (SMD) of cytokine concentrations between patients with nAMD and controls.
Results :
Among the 3983 eyes in 89 studies, aqueous concentrations (standard mean difference, 95% confidence interval, and p-value) of IP-10 (0.86, 0.56 to 1.15, p<0.00001), MCP-1 (0.59, 0.41 to 0.77, p<0.00001), MIG (0.63, 0.31 to 0.94, p=0.0001), TGF-β (0.45, 0.07 to 0.82, p=0.02) and VEGF (0.52, 0.21 to 0.84, p=0.001) were significantly higher in patients with nAMD compared to healthy controls. No differences, failed sensitivity analyses or insufficient data were found between patients with nAMD and healthy controls for the concentrations of the remaining cytokines and with all vitreous samples. The median size of included studies were 22 eyes. Of the 5 aqueous cytokines and 5 vitreous cytokines for which we found a significant elevation in cytokine concentration in RVO nAMD vs. controls, previous studies had found them to be decreased or not significantly different in RVO nAMD vs. controls in 45 instances.
Conclusions :
Several cytokines in addition to VEGF have the potential to be useful biomarkers and therapeutic targets in nAMD. Studies assessing cytokine relationships in nAMD may have inconsistent results due to small sample sizes.
This is a 2020 ARVO Annual Meeting abstract.