Aqueous flare and inflammatory factors in macular edema with central retinal vein occlusion: a case series

Hidetaka Noma,Maria Tatsugawa,Tatsuya Mimura,Katsunori Shimada

doi:10.1186/1471-2415-13-78

Abstract

BackgroundThe association of inflammatory factors and the aqueous flare value with macular edema in central retinal vein occlusion (CRVO) patients remains unclear. We investigated the relations between the aqueous flare value and vitreous levels of vascular endothelial growth factor (VEGF), soluble intercellular adhesion molecule-1 (sICAM-1), and interleukin-6 (IL-6) in patients with CRVO and macular edema or patients with idiopathic macular hole (MH).MethodsIn 38 patients who underwent unilateral vitrectomy (21 CRVO patients and 17 MH patients), vitreous samples were obtained during vitrectomy to measure VEGF, sICAM-1, and IL-6. Retinal ischemia was evaluated from capillary non-perfusion on fluorescein angiography, and the CRVO patients were classified into nonischemic or ischemic groups. Aqueous flare values were measured with a laser flare meter and macular edema was examined by optical coherence tomography.ResultsThe median aqueous flare value increased significantly across the three groups (MH group < nonischemic CRVO group < ischemic CRVO group). There was a significant correlation between the flare value and vitreous levels of VEGF, sICAM-1, and IL-6 in the CRVO group. The flare value was also significantly correlated with the severity of macular edema in the CRVO group.ConclusionsInflammation and/or ischemia may increase vascular permeability and disrupt the blood-aqueous barrier by increasing levels of inflammatory factors in patients with CRVO and macular edema.

Highlights

The association of inflammatory factors and the aqueous flare value with macular edema in central retinal vein occlusion (CRVO) patients remains unclear
There was a significant correlation between the aqueous flare value and the vitreous fluid levels of vascular endothelial growth factor (VEGF), soluble intercellular adhesion molecule-1 (sICAM-1), and IL-6 in the CRVO group (ρ = 0.73, P = 0.001, ρ = 0.66, P = 0.003, and ρ = 0.63, P = 0.005, respectively) (Table 3)
The present study revealed that vitreous fluid levels of VEGF, sICAM-1, and IL-6 were significantly correlated with the aqueous flare value and with the severity of macular edema in CRVO patients, and that there was a significant correlation between the flare value and the severity of macular edema

Summary

Introduction

The association of inflammatory factors and the aqueous flare value with macular edema in central retinal vein occlusion (CRVO) patients remains unclear. We investigated the relations between the aqueous flare value and vitreous levels of vascular endothelial growth factor (VEGF), soluble intercellular adhesion molecule-1 (sICAM-1), and interleukin-6 (IL-6) in patients with CRVO and macular edema or patients with idiopathic macular hole (MH). We recently reported that vitreous fluid levels of inflammatory factors were significantly correlated with the severity of macular edema in CRVO patients [5,6], suggesting that inflammation is important in the development of macular edema. We investigated the relation between macular edema and inflammatory parameters (flare value and vitreous fluid levels of VEGF, sICAM-1, and IL-6) in patients with CRVO

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Discussion

Conclusion