Abstract
Purpose :
First, to investigate the effectiveness of corticosteroid therapy combined with anti-vascular endothelial growth factor (VEGF) for chronic retinal vein occlusion (RVO). Second, to examine the differences in intraocular inflammatory cytokines between good responders (GR) and non-responders (NR).
Methods :
The subjects of this retrospective, observational study were 42 eyes of 42 patients with refractory macula edema (ME) due to chronic RVO who had received only “anti-VEGF” (VE:Tx) for ≥1 year. There were 18 men; mean age 72 years. We investigated whether recurrence intervals of ME could be prolonged by “anti-VEGF drugs combined with sub-Tenon injection of triamcinolone acetonide” (Com:Tx). GR group was defined as patients whose recurrence intervals were prolonged by at least 2 weeks compared with those of VE:Tx. Moreover, just prior to the sub-Tenon injection of Com:Tx, aqueous humor were collected and the following inflammatory cytokines were measured and compared between GR and NR groups: CCL11, MCP-3, IP-10, CCL13, G-CSF, GM-CSF, IL-1α, IL-15, IL-4, M-CSF, MMP-9, TNF-α, MCP-1, CXCL-1, CXCL12, IL-8, galectin-1, IFN-γ, IL-12, IL-2, IL-6, MMP-1, PDGF-AA, and VEGF-A. These results were analyzed by nominal logistic regression after stepwise variable selection.
Results :
There were 26 eyes (68%) in GR group. Inflammatory cytokines were not significantly different between GR and NR groups. However, nominal logistic analyses showed that higher IL-1α (p=0.016) and lower IL-5 (0.015), IL-6 (0.022), and galectin-1 (0.015) were significantly associated with prolonged recurrence intervals of ME.
Conclusions :
Combined therapy of anti-vascular endothelial growth factor and corticosteroids therapy for chronic RVO was effective in 68% of patients. Moreover, higher IL-1α and lower IL-5, IL-6, and galectin-1 (0.02) were factors associated with this effectiveness.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.