Abstract
Purpose :
Quantitative analysis of human aqueous humor (AH) was performed to investigate glucose metabolism in patients with central retinal vein occlusion (CRVO), and to explore metabolic changes after anti-vascular endothelial growth factor (VEGF) treatment.
Methods :
AH samples were collected from 35 patients. Participants diagnosed with CRVO (n=15) were compared to participants who underwent cataract surgery (n=20). Thirteen of the participants with CRVO received second-round anti-VEGF treatments. Ultra-high performance liquid chromatography tandem-mass spectrometry (uHPLC-MS/MS) was used to quantify metabolites of the AH. Central macular thickness (CMT) and retinal ganglion cell layer (RGC) thickness were measured using spectral-domain optical coherence tomography.
Results :
Thirteen metabolites involved in the glycolytic pathway and tricarboxylic acid cycle were identified. Among these metabolites, succinate, glutamate, and glutamine were significantly decreased for the CRVO group (P=0.028, 0.009, and 0.017, respectively). The α-ketoglutarate/citrate (K/C) ratio had a significant positive correlation with glutamine levels for both control (r=0.609, P=0.035) and CRVO groups (r=0.674, P=0.006). A significant increase in lactate was observed after intravitreal anti-VEGF administration (P=0.045); CMT was negatively correlated with this increase (r=-0.774, P=0.014). RGC thickness was negatively correlated with increases in both glutamine (r=-0.619, P=0.024) and glucose (r=-0.754, P=0.003).
Conclusions :
These results indicate that, compared to glucose metabolism, glutamine pathways are more susceptible to ischemia of the AH, and may therefore serve as potential targets for CRVO therapy. The glycolytic pathway might be enhanced after intravitreal anti-VEGF injection, which is an important insight into CRVO pathophysiology and the effects of anti-VEGF therapy.
This is a 2020 ARVO Annual Meeting abstract.