Aqueous cytokines as predictors of macular edema in patients with diabetes following uncomplicated phacoemulsification cataract surgery.

Ning Dong,Liqun Chu,Bing Xu,Xin Tang,Bingsong Wang

doi:10.1155/2015/126984

Abstract

This study aims to ascertain whether cytokines in the aqueous humor can predict macular edema (ME) in diabetic patients following uncomplicated phacoemulsification cataract surgery. Undiluted aqueous humor samples were obtained from 136 consecutive type 2 diabetic patients who underwent cataract surgery. The concentrations of 27 cytokines were measured in aqueous humor using the multiplex bead immunoassay. At the final follow-up examination, 116 patients completed 4 weeks of follow-up, and the incidence of macular edema was 29.31% (34 patients) 4 weeks after cataract surgery. Compared to the ME (−) patients, the concentrations of interleukin-1β (IL-1β) (P < 0.001), IL-6 (P < 0.001), IL-8 (P < 0.001), interferon-induced protein-10 (IP-10) (P = 0.003), monocyte chemotactic protein-1 (MCP-1) (P < 0.001), and vascular endothelial growth factor (VEGF) (P < 0.001) in the ME (+) patients were significantly higher. In addition, the aqueous levels of IL-1β (r = 0.288), IL-6 (r = 0.345), IL-8 (r = 0.256), IP-10 (r = 0.377), MCP-1 (r = 0.423), and VEGF (r = 0.279) were positively correlated with the postoperative foveal center point thickness (FCPT). However, the aqueous levels of IL-10 (P = 0.003) and IL-12 (P = 0.017) were significantly lower in patients with ME. These results suggest IL-1β, IL-6, IL-8, IL-10, IL-12, IP-10, MCP-1, and VEGF may be potential predictors of postoperative macular thickness in patients with diabetes following uncomplicated phacoemulsification cataract surgery.

Highlights

Diabetes mellitus (DM) has been a leading public health problem in China for the last 10 years and imposes a heavy economic burden on Chinese patients [1]
Inclusion criteria were the presence of diabetes mellitus and the absence of any retinal or optic nerve disease except diabetic retinopathy in the study group
The incidence of macular edema (ME) has been reported to range from 4% [10] to 11% [17] in nondiabetic patients following uncomplicated phacoemulsification; the prevalence of ME ranges from 20% to 50% in patients with diabetes following uncomplicated phacoemulsification [8, 9]

Summary

Introduction

Diabetes mellitus (DM) has been a leading public health problem in China for the last 10 years and imposes a heavy economic burden on Chinese patients [1]. Diabetic patients have been reported to have a higher prevalence of cataracts and an increased risk of developing cataracts earlier than patients without diabetes [2]. The incidence of postoperative complications is decreasing with the development of phacoemulsification cataract surgery and posterior chamber intraocular lens implantation. Anterior segment inflammation, progression of diabetic retinopathy, and macular edema (ME) are the most common complications in patients with diabetes following uncomplicated phacoemulsification cataract surgery [3, 4]. ME is one of the main causes of unfavorable visual outcomes following uncomplicated cataract surgery and can result in permanent visual loss [5,6,7]. The reported incidence of ME ranges from 20% to 50% in patients with diabetes following uncomplicated phacoemulsification cataract surgery [8, 9]

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