Abstract
Purpose:The role of inflammation and cytokines in AMD and anti-Vascular Endothelial Growth Factor (anti-VEGF) treatment remains unclear. Therefore, this study aimed to examine whether anti-VEGF treatment for exudative Age-related Macular Degeneration (AMD) affects aqueous flare value (an indicator of inflammation), functional-morphologic parameters, and aqueous humor levels of cytokines or inflammatory mediators.Methods:We compared aqueous humor levels of 8 cytokines, growth factors (including VEGF), and inflammatory mediators in 43 patients who received anti-VEGF treatment with aflibercept for AMD and 24 healthy controls by the suspension array method. In addition, we measured aqueous flare values with a laser flare meter and Central Macular Thickness (CMT) and Macular Volume (MV) by optical coherence tomography.Results:The patient group had a significantly higher aqueous flare value than the control group. At baseline, CMT showed significant correlations with aqueous humor levels of soluble intercellular adhesion molecule-1 (sICAM-1), monocyte chemoattractant protein 1 (MCP-1), interleukin (IL)-6, and IL-8 and MV, with aqueous humor levels of VEGF, sICAM-1, MCP-1, IL-6, and IL-8. Moreover, we found significant correlations between aqueous flare value and aqueous humor levels of MCP-1, IL-6, IL-8, and interferon-gamma–inducible protein 10. One month after anti-VEGF treatment, the patient group showed a significant correlation between the change in MV and improvement in best-corrected visual acuity (BCVA); CMT showed no such correlation.Conclusion:Inflammation appears to be involved in AMD. Change in MV may be an index of improvement in BCVA in patients receiving anti-VEGF treatment for AMD.
Highlights
About 10% of the population over the age of 50 show Agerelated Macular Degeneration (AMD), and it is the most common cause of irreversible visual loss in this age group [1]
Change in Macular Volume (MV) may be an index of improvement in best-corrected visual acuity (BCVA) in patients receiving anti-vascular endothelial growth factor (VEGF) treatment for AMD
The present study found that the aqueous flare value was significantly higher in the AMD group than in the control group, suggesting that inflammation is present in the eyes of patients with AMD
Summary
About 10% of the population over the age of 50 show Agerelated Macular Degeneration (AMD), and it is the most common cause of irreversible visual loss in this age group [1]. 210 The Open Ophthalmology Journal, 2021, Volume 15 pegaptanib, an aptamer of VEGF, bevacizumab and ranibizumab, anti-VEGF antibodies and aflibercept, a VEGF binding agent [5 - 7]. All these agents showed efficacy in improving vision in AMD in large multicenter studies [8]. Sterile intraocular inflammation has been reported as a potential side effect of anti-VEGF treatment [9]. Of interest in this context is that inflammation is found in AMD before treatment [10]. The aqueous flare value reflects increased protein content in the anterior chamber, which results from the breakdown of the bloodocular barrier, including the Blood-Retinal Barrier (BRB), in retinal diseases and treatments [12 - 17]
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