Changes in aqueous cytokines after intravitreal triamcinolone versus bevacizumab for macular oedema in branch retinal vein occlusion

Abstract

ABSTRACT.Purpose: To investigate the changes in the aqueous levels of various cytokines after intravitreal triamcinolone or bevacizumab for branch retinal vein occlusion (BRVO). Methods: Twenty-four eyes with macular oedema associated with BRVO and six eyes of six patients undergoing cataract surgery participated in this study. Each patient with BRVO randomly received an intravitreal injection of either 4 mg triamcinolone or 1.25 mg bevacizumab. Aqueous samples were obtained before and 4 weeks after the intravitreal injection in the BRVO group and before surgery in the control group. Aqueous concentrations of 16 cytokines were measured via multiplex bead assay. Results: Prior to the administration of the drugs, aqueous levels of interleukin (IL)-6, IL-8, IL-17 and vascular endothelial growth factor (VEGF) were significantly higher in the BRVO group than in the control group (p = 0.044, p = 0.013, p < 0.001, and p = 0.008, respectively). Between the control group and the BRVO group, no significant differences were noted between pre-and postinjection best-corrected visual acuity (p = 0.60, p = 0.54) and central foveal thickness (p = 0.47, p = 0.82). In the triamcinolone group, levels of IL-6, IL-17, IP-10, platelet-derived growth factor (PDGF)-AA and VEGF were reduced significantly (p = 0.012, p < 0.001, p < 0.001, p = 0.015, and p < 0.001, respectively). But in bevacizumab group, only VEGF was significantly reduced (p < 0.001). Between the IVTA group and the IVBe group, no significant differences in the changes in VEGF levels were noted (p = 0.06). Conclusion: Triamcinolone injection reduces plural inflammatory cytokines in BRVO, while bevacizumab has no influence on other cytokines as selective anti-VEGF therapy. No differences in the therapeutic effect were noted between an inhibition of plural inflammatory cytokines and an inhibition of VEGF only.

Anti‐VEGF treatment in branch retinal vein occlusion: a real‐world experience over 4 years

“…Nowadays, intravitreal anti‐VEGF treatment has been accepted as the standard of care for exudative ME by selectively suppressing VEGF levels (Sohn et al. ). Some studies also investigated the role of combining anti‐VEGF with laser treatment.…”

“…Since the publication of the Branch Vein Occlusion Study (BVOS), grid laser photocoagulation was performed for the treatment of BRVO-associated ME. Nowadays, intravitreal anti-VEGF treatment has been accepted as the standard of care for exudative ME by selectively suppressing VEGF levels (Sohn et al 2014). Some studies also investigated the role of combining anti-VEGF with laser treatment.…”

Effect of intravitreal dexamethasone implant on intra‐ocular cytokines and chemokines in eyes with retinal vein occlusion

“…In a previous study, intra‐ocular VEGF concentrations could be reduced during bevacizumab treatment, while no effects were found on cytokine concentrations of other mediators (Sohn et al. ). Funk et al.…”

“…; Sohn et al. ). As VEGF is known to be a potent permeability factor, it is a major regulator during the development of ME.…”

Dexamethasone Intravitreal Implant Rescue Treatment for Bevacizumab Refractory Macular Edema Secondary to Branch Retinal Vein Occlusion

“…It is possible that the cases of macular edema in our study population refractory to intravitreal anti-VEGF injection involved pathological changes unrelated to VEGF. Furthermore, steroid injection can reduce interleukin-6 [2526] and interleukin-8 [26], levels, which cannot be modulated by anti-VEGF therapy.…”