Цитокиновый профиль интраокулярных жидкостей в прогнозировании макулярного отека при хирургическом лечении регматогенной отслойки сетчатки

Abstract

Purpose. Based on the study of cytokines content in the vitreous body and subsilicone fluid (SSF), to evaluate risk factors for the development of macular edema in patients with rhegmatogenous retinal detachment (RRD) after endovitreal surgery. Material and methods. An analysis of the treatment of 28 patients (28 eyes) with RRD complicated by PVR Sr type 1–4 involving the macular area was carried out. Patients underwent vitrectomy or vitrectomy combined with circumferential scleral indentation and silicone oil tamponade. During the initial intervention, the vitreous humor was collected, and upon completion of the silicone tamponade, the CVS was taken. In both obtained samples, the quantitative content of the following cytokines was determined by enzyme-linked immunosorbent assay (ELISA): GIF1α, interleukins (IL) – 4, 6, 17, TGF-β1, VEGF and TNF-α. Besides standard ophthalmological examination, all patients underwent optical coherence tomography in the postoperative period with assessment of the thickness and volume of the macular retinal area. Results. Connection between the quantitative content of cytokines in the vitreous body and preoperative indices showed significant negative correlation between TNF-a content and the number of detached quadrants as well as between the «visual field on the sum of 8 meridians» index and VEGF content. The values of TNF-αquantitative content had a pronounced negative correlation with the index «visual field on the sum of 8 meridians» after surgery, and positive correlation with the time of silicon oil finding in the vitreous cavity and the number of detached quadrants before treatment. We also found that IL-6 content had a significant positive correlation with the thickness of the central retinal zone and a negative correlation with the total visual field at the stage of treatment completion. The data obtained by comparing quantitative content of cytokines in CSF in patients with and without macular edema showed a statistically significant positive correlation between the risk of macular edema and content of IL-6, as well as TNF-α. Conclusion. Significant correlations were determined between the risks of macular edema and cytokines concentration in subsilicon-oil fluid that have proinflammatory properties (TNF-αand IL-6). Quantitative TNF-αcontent in sub-silicone fluid has a direct correlation with the time of silicone oil presence in the vitreous cavity, which may determine early completion of tamponade. Quantitative content of the cytokines studied in the vitreous body cannot be a predictor of macular edema development in the postoperative period. Key words: cytokine profile, regmatogenous retinal detachment, subsilicone fluid, intraocular fluid, macular edema