Cytokines and Growth Factors as Predictors of Response to Medical Treatment in Diabetic Macular Edema

Torres-Costa, Sónia; Valente, Maria Carolina Alves; Falcão‐Reis, Fernando; Falcão, Manuel

doi:10.1124/jpet.119.262956

Cited by 12 publications

(11 citation statements)

References 62 publications

(133 reference statements)

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“…[16][17][18] IL6 is a pro-inflammatory cytokine that has been shown to increase vascular permeability and promote angiogenesis. 19 It correlates with severity of diabetic retinopathy as well as DME. 20 IL6 may increase vascular permeability both directly or indirectly by upregulating VEGF.…”

Section: Discussionmentioning

confidence: 99%

Impact of obstructive sleep apnea on the expression of inflammatory mediators in diabetic macular edema

Yang

Somani

2022

European Journal of Ophthalmology

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Purpose To determine differences in inflammatory markers expressed in diabetic macular edema (DME) patients with and without obstructive sleep apnea (OSA). Methods This was a prospective, cross-sectional study. Patients with treatment naive DME were enrolled in the study. They were stratified into 2 groups based on Apnea Hypopnea Index (AHI) from overnight polysomnography: OSA + (AHI ≥ 15) and OSA – (AHI<15). Multiplex immunoassay was performed for aqueous and serum cytokines including VEGF, placental growth factor (PGF), ICAM, IL2, IL3, IL6, IL8, IL10, IL17, vascular cell adhesion molecule-1 (VCAM1), monocyte attractant protein-1 (MCP1), epidermal growth factor (EGF) and platelet derived growth factor (PDGF). Statistical significance was defined as p < 0.004 using Bonferroni correction. Results 32 DME positive patients were enrolled in the study; of which 17 patients were OSA + and 15 OSA-. The OSA + cohort had significantly higher levels of serum EGF (p = 0.003), and trended towards higher levels of most serum cytokines including ICAM and IL6. OSA- cohort had significantly higher levels of aqueous IL17 compared to the OSA + cohort (2.97 ± 1.7 vs. 1.4 ± 0.46 pg/mL, p = 0.004). There were no significant differences in other aqueous cytokines. Conclusions OSA + group trended towards higher levels of most serum inflammatory markers, suggesting a greater pro-inflammatory state. However, they did not have significantly greater level of aqueous cytokines.

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Section: Discussionmentioning

confidence: 99%

Impact of obstructive sleep apnea on the expression of inflammatory mediators in diabetic macular edema

Yang

Somani

2022

European Journal of Ophthalmology

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“…e pathogenesis of DME is complex, involving VEGF and other inflammatory mediators [6]. Compared with anti-VEGF therapy, steroids can reduce not only the levels of VEGF but also those of other inflammatory cytokines [17].…”

Section: Discussionmentioning

confidence: 99%

Choroidal Structural Changes of Posterior Subtenon Triamcinolone Acetonide Injection in Eyes with Refractory Diabetic Macular Edema

Liu

Hou

et al. 2022

Journal of Ophthalmology

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Purpose. To access the choroidal structural changes of posterior subtenon triamcinolone acetonide (PSTA) injection in eyes with refractory diabetic macular edema (DME). Methods. Patients with refractory DME were enrolled and followed for 4 weeks after switching to PSTA injection. All patients underwent spectral-domain optical coherence tomography with enhanced depth imaging, and the choroidal images were binarized into the luminal area and total choroidal area. Subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) were evaluated before and after switching treatments. Results. After switching to PSTA treatment, the final best-corrected visual acuity and central subfield thickness in eyes with refractory DME were significantly improved compared to the baseline values ( P = 0.002 and P < 0.001 , respectively). Both the SFCT and CVI decreased during the follow-up period, and significant decreases were observed at 4-week follow-up ( P < 0.001 and P = 0.012 , respectively). The linear regression analysis showed a significant correlation between the baseline SFCT and the final visual outcomes ( P = 0.047 ). Conclusions. The alterations of SFCT and CVI in this study suggest that the choroidal vasculature is involved in the pathogenesis of refractory DME and could be affected by PSTA treatment. SFCT rather than CVI may be a prognostic biomarker for eyes with refractory DME.

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“…DME has complex pathogenesis involving VEGF and other in ammatory mediators [7]. Unlike anti-VEGF therapy, steroids can reduce levels of other in ammatory cytokines in addition to VEGF levels [20]. Thus, steroids should be considered for some cases that are refractory to anti-VEGF therapy.…”

Section: Discussionmentioning

confidence: 99%

Short-term effects of intravitreal dexamethasone implant on choroidal structure in eyes with refractory diabetic macular edema Contributors

Bilici

Serbest

Uğurbaş

2022

Preprint

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Purpose To evaluate choroidal structural changes after intravitreal dexamethasone implant (IDI) in eyes with diabetic macular edema (DME) refractory to anti-vascular endothelial growth factor (VEGF) therapy. Methods Twenty-three eyes of 14 patients with DME refractory to anti-VEGF therapy were included in this retrospective study. Detailed ophthalmological examinations were recorded and optical coherence tomography (OCT) images were obtained before and 3 months after IDI. Choroidal images were binarized into the luminal area and total choroidal area. Subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) were calculated. Results The mean best-corrected visual acuity (BCVA) and central macular thickness (CMT) were improved significantly (from 0.94 to 0.81 LogMAR, p = 0.02, and from 464 to 371 µ, p = 0.01, respectively) after IDI. There were no significant changes in both SCFT and CVI at the end of the follow-up period (from 446.3 to 428.8 µ, p = 0.51 and from 63.1 to 63.7 p = 0.35, respectively). Conclusion IDI in eyes with DME refractory to anti-VEGF therapy improves BCVA and CMT but has no significant effect on SCFT and CVI in short term.

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Cytokines and Growth Factors as Predictors of Response to Medical Treatment in Diabetic Macular Edema

Cited by 12 publications

References 62 publications

Impact of obstructive sleep apnea on the expression of inflammatory mediators in diabetic macular edema

Impact of obstructive sleep apnea on the expression of inflammatory mediators in diabetic macular edema

Choroidal Structural Changes of Posterior Subtenon Triamcinolone Acetonide Injection in Eyes with Refractory Diabetic Macular Edema

Short-term effects of intravitreal dexamethasone implant on choroidal structure in eyes with refractory diabetic macular edema Contributors

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