Comparison of Intraocular Cytokine Levels of Choroidal Neovascularization Secondary to Different Retinopathies

Abstract

Purpose: To investigate and compare the aqueous concentrations of vascular endothelial growth factor (VEGF) and other inflammatory cytokines in various choroidal neovascularization (CNV) diseases and types.Methods: This observational study included 127 naive eyes with CNV and 43 control eyes with cataracts. Aqueous humor (AH) samples were obtained prior to intravitreal anti-VEGF injection or cataract surgery. Multiple inflammatory cytokines, including VEGF, interleukin (IL) 6, IL-8, IL-10, interferon-inducible protein 10 (IP-10), and monocyte chemotactic protein 1 (MCP-1) levels, were measured using a multiplex bead assay. The angiogenesis index was defined as the ratio of IP-10 to MCP-1. In addition, the relationship among AH cytokine levels, central macular thickness (CMT), and CNV size on optical coherence tomography angiography (OCTA) was evaluated.Results: Except in the myopic CNV group (P = 0.452), the AH concentration of VEGF was significantly higher in all other CNV groups than in the control group (P < 0.05 for all comparisons). IL-8, IL-10, IP-10, and MCP-1 levels (P < 0.05 for all groups) were significantly higher in all CNV diseases except those with neovascular central serous chorioretinopathy. The angiogenesis index was significantly higher in all CNV diseases (P < 0.05 for all comparisons). The VEGF level may be associated with the size of the CNV on OCTA (p = 0.043).Conclusions: The level of intraocular inflammatory cytokines varied among different CNV diseases and CNV types. Therefore, the angiogenesis index may be a more sensitive indicator of angiogenesis.

Difference in aqueous concentration and vitreous mass of cytokines in high myopias with and without choroidal neovascularization

“…In the mCNV group, the AH concentration and vitreous mass of cytokines had no correlation with CMT or size of CNV. The possible explanations are as follows: In other CNV diseases, such as AMD, type 1 CNV did not affect visual activity in the early stages and patients seek medical attention later, when the size of CNV was large and VEGF level were significantly elevated ( 11 ). In contrast, the majority of mCNV are type 2 CNV, which rapidly affected vision as soon as it appeared.…”

“…We defined the central macular thickness as the average retinal thickness within the 1-mm diameter central field of the Early Treatment Diabetic Retinopathy Study. The optical coherence tomography angiography (OCTA) images were produced using a split-spectrum amplitude decorrelation angiography (SD-OCT) equipment (RTVue-XR Avanti; Optovue, Inc, Fremont, CA).Then the size of CNVs was marked with the manual selection tools and calculated based on the built-in software ( 11 ). Images with poor quality (quality <7) were excluded from the analysis.…”

“…Each cytokine concentration (pg/mL) was calculated based on the standard curve provided by the kit. All procedures were carried out in a dark environment with room temperature illumination to prevent degradation brought on by light ( 6 , 11 ). Previous studies found that the majority of the proteins presented in both aqueous and vitreous fluid were in similar quantities ( 15 ) and cytokines such as VEGF demonstrated a strong correlation in vitreous and aqueous of patients ( 16 ).…”

“…The inflammatory internal microenvironment in HM eyes also plays an important role in the progression of CNV and myopia. AH and vitreous concentration of inflammatory cytokines, such as interleukin-8(IL-8), and monocyte chemotactic protein-1 (MCP-1), and interferon-inducible protein-10(IP-10), were significantly increased in CNV diseases ( 11 – 13 ). And these cytokines have been demonstrated to be mediators of inflammation and angiogenesis in various ocular and systemic diseases ( 12 ), which also induces VEGF upregulation while participating in the inflammatory response ( 6 ).…”

Aqueous Humor Cytokine Profiles of Pachychoroid Spectrum Diseases

“…Our study showed that the proangiogenic cytokine VEGF levels were distinctly upregulated in the CSC group than in the control group. Liu et al have reported that the AH concentration of VEGF was signi cantly higher in various CNV diseases including CSC [14] . However, there was evidence that aqueous or plasma VEGF levels in patients with acute or chronic CSC were downregulated compared with the controls [15,16] .…”