Vitreous Levels of Vascular Endothelial Growth Factor and Intercellular Adhesion Molecule 1 Are Related to Diabetic Macular Edema

Funatsu, Hideharu; Yamashita, Hidetoshi; Sakata, Kumi; Noma, Hidetaka; Mimura, Tatsuya; Suzuki, Motohiro; Eguchi, Shuichiro; Hori, Shingo

doi:10.1016/j.ophtha.2004.11.045

Cited by 195 publications

(131 citation statements)

References 21 publications

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“…11 The vitreous fluid of subjects with DME has been shown to have raised levels of VEGF, which plays a major role in increasing vascular permeability causing the progression of DME. 12 These anti VEGF antibodies down regulate VEGF and reduce capillary permeability thus decreasing the resultant edema. Decreased foveal thickness facilitates laser treatment and reduces the need for high laser energy.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal Bevacizumab as an Adjunct to Laser for Diffuse Diabetic Macular Edema

Nawaz¹,

Shaveta²,

Sofi³

et al. 2015

jemds

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ABSTRACT:Background: Diabeteic retinopathy with its manifestation in the form of diabetic macular edema has become a leading cause of blindness all over the world. AIM: In the present study we evaluated, the anatomical and visual acuity outcomes after intravitreal bevacizumab and laser in Diffuse DME. MATERIALS AND METHODS: An OCT guided pilot study, evaluating the effect of intravitreal bevacizumab as an adjunct to laser, of 40 eyes of 40 diabetic patients having diffuse diabetic macular edema with maximum retinal thickness (MRT) more than or equal to 350 µm was conducted at Government Medical College & Hospital, Chandigarh, India. The patients had minimum follow up of 6 months. RESULTS: There was a significant decrease in maximum retinal thickness with significant gain in visual acuity at 6 month. CONCLUSIONS: Intravitreal bevacizumab combined with laser photocoagulation has better outcomes in the management of patients with diffuse diabetic macular edema. Since ours is a pilot study, further studies with larger number of patients and longer follow ups are essential to conclusively establish the superiority of IVB combined with laser photocoagulation in the management of DME.

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Section: Discussionmentioning

confidence: 99%

Intravitreal Bevacizumab as an Adjunct to Laser for Diffuse Diabetic Macular Edema

Nawaz¹,

Shaveta²,

Sofi³

et al. 2015

jemds

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“…The elevated cytokines include VEGF, MCP-1, IL-6, IL-8, interferon γ-induced protein-10. 119,130-132 Funatsu et al [120][121][122] have also previously reported increased levels of ICAM-1, IL-6, Angiotensin II, and VEGF in DR and DMO. Klein et al 133 reported that sVCAM-1 and TNFα are associated with higher odds of developing more severe DR in patients with renal disease and PDR.…”

Section: Scientific Basismentioning

confidence: 92%

“…118 Vitreous levels of several inflammatory cytokines (including IL-6, IL-8, and monocyte chemotactic protein (MCP)-1) are increased in eyes with DMO and PDR. 119 In other studies, Funatsu et al [120][121][122] have reported significant elevations of VEGF, ICAM-1, IL-6, MCP-1, and pigment epithelium-derived factor, which correlated with retinal vascular permeability changes. In addition to this pathway, stimulation of 6-N-acetyl glucosaminyl-transferase in leukocyte can result in more modification of glycans on its surface thus inducing leukocyte rolling interactions to endothelial selectins.…”

Section: Scientific Basismentioning

confidence: 92%

A review of therapies for diabetic macular oedema and rationale for combination therapy

Amoaku

Saker

Stewart

2015

Eye

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Diabetic macular oedema (DMO) is responsible for significant visual impairment in diabetic patients. The primary cause of DMO is fluid leakage resulting from increased vascular permeability through contributory anatomical and biochemical changes. These include endothelial cell (EC) death or dysfunction, pericyte loss or dysfunction, thickened basement membrane, loss or dysfunction of glial cells, and loss/change of EC Glycocalyx. The molecular changes include increased reactive oxygen species, pro-inflammatory changes: advanced glycation end products, intracellular adhesion molecule-1, Complement 5-9 deposition and cytokines, which result in increased paracellular permeability, tight junction disruption, and increased transcellular permeability. Laser photocoagulation has been the mainstay of treatment until recently when pharmacological treatments were introduced. The current treatments for DMO target reducing vascular leak in the macula once it has occurred, they do not attempt to treat the underlying pathology. These pharmacological treatments are aimed at antagonising vascular endothelial growth factor (VEGF) or non-VEGF inflammatory pathways, and include intravitreal injections of anti-VEGFs (ranibizumab, aflibercept or bevacizumab) or steroids (fluocinolone, dexamethasone or triamcinolone) as single therapies. The available evidence suggests that each individual treatment modality in DMO does not result in a completely dry macula in most cases. The ideal treatment for DMO should improve vision and improve morphological changes in the macular (eg, reduce macular oedema) for a significant duration, reduced adverse events, reduced treatment burden and costs, and be well tolerated by patients. This review evaluates the individual treatments available as monotherapies, and discusses the rationale and potential for combination therapy in DMO.

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“…Intercellular adhesion molecule 1 (ICAM-1) and CD18 are upregulated and contribute to increased leukocyte adhesion to the endothelial wall. This is turn results in endothelial cell injury and death (Funatsu et al, 2005;Miyamoto et al, 1998;Miyamoto et al, 1999;Schroder et al, 1991). Elevated expression of matrix metalloproteases in the retina may also facilitate increases in vascular permeability and degradation of tight junction complexes, leading to BRB dysfunction (Giebel et al, 2005).…”

Section: Pathogenesismentioning

confidence: 99%

Endophthalmitis

Phillip¹,

Michelle²

2012

Advances in Ophthalmology

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Vitreous Levels of Vascular Endothelial Growth Factor and Intercellular Adhesion Molecule 1 Are Related to Diabetic Macular Edema

Cited by 195 publications

References 21 publications

Intravitreal Bevacizumab as an Adjunct to Laser for Diffuse Diabetic Macular Edema

Intravitreal Bevacizumab as an Adjunct to Laser for Diffuse Diabetic Macular Edema

A review of therapies for diabetic macular oedema and rationale for combination therapy

Endophthalmitis

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