Abstract
Objectives: To compare the aqueous concentrations of inflammatory and angiogenetic factors in vitrectomized vs. non-vitrectomized eyes with diabetic macular edema (DME).Methods: Aqueous samples were obtained from 107 eyes with DME before intravitreal injection of anti-VEGF, 36 eyes with previous pars plana vitrectomy (PPV) combined with pan-retinal endolaser photocoagulation (PRP), and 71 treatment-naïve. Interleukin (IL)-6, IL-8, interferon-induced protein (IP)-10, monocyte chemoattractant protein (MCP)-1, and vascular endothelial growth factor (VEGF) were measured by cytometric bead array (CBA). Optical coherence tomography (OCT) was used for measuring central retinal thickness (CRT).Results: IL-6, IL-8, IP-10, and MCP-1 in aqueous humor of DME vitrectomized eyes were significantly higher than in non-vitrectomized DME eyes, while VEGF was lower than in non-vitrectomized DME eyes. VEGF in aqueous humor significantly correlated with CRT for DME in non-vitrectomized DME eyes. IL-6, IL-8, IP-10, and MCP-1 in aqueous humor were not significantly associated with VEGF for DME in vitrectomized eyes.Conclusions: Inflammation might play an important role in the pathogenesis of DME in vitrectomized eyes. Moreover, inflammation might play a central role in the development of DME via the VEGF-independent pathway. Thus, anti-inflammatory therapy might be a strategy for DME in vitrectomized eyes.
Highlights
Anti-VEGF intravitreous injection is emerging as first-line therapy for diabetic macular edema (DME) [1]
The study by Yanyali et al [3] demonstrated that anti-VEGF therapy in vitrectomized eyes with DME had no effect on visual acuity or foveal thickness, which indicated that the mechanism of DME post-pars plana vitrectomy (PPV) might be different from DME without surgery due to the changes in the microenvironment
We found that the inflammatory factors including IL-6, IL-8, induced protein (IP)-10, and MCP-1 levels were higher in vitrectomized DME eyes than in non-vitrectomized DME eyes
Summary
Anti-VEGF intravitreous injection is emerging as first-line therapy for diabetic macular edema (DME) [1]. The effectiveness of anti-VEGF therapy in eyes after pars plana vitrectomy (PPV) remains uncertain. The study by Yanyali et al [3] demonstrated that anti-VEGF therapy in vitrectomized eyes with DME had no effect on visual acuity or foveal thickness, which indicated that the mechanism of DME post-PPV might be different from DME without surgery due to the changes in the microenvironment. IL-6 levels are associated with the recurrence of DME after anti-VEGF treatment [7]. IL-8 is believed to be involved in inflammation-mediated angiogenesis and serves as a fundamental factor in the inflammatory basis of diabetic retinopathy (DR) [8]. Aqueous MCP-1 levels are elevated in DME eyes [15]
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