Aqeuous humor cytokines concentration changes in patients with diabetic macular edema after intravitreal pharmacotherapy

Abstract

Purpose: to analyze intraocular fluid (IOF) cytokine concentrations in patients with diabetic macular edema (DME) after intravitreal therapy with angiogenesis inhibitors or corticosteroids (CS).Materials and methods. 44 patients (45 eyes) were divided in 2 groups depending on the therapy: group 1 (n = 19) received an angiogenesis inhibitor (aflibercept) while group2 (n = 26) received CS (dexamethasone implant). They were tested for IOF cytokine levels by Milliplex® Map Human Cytokine/Chemokine Panel at treatment start and 3 months after either 3 monthly injections of aflibercept or a single dexamethasone implant injection.Results. The concentrations of ten cytokines (IL-8/CXCL8, IP-10/CXCL10, MCP-1/CCL2, PDGF-AA, GROα/CXCL1, VEGF-A, MIP-1β/CCL4, IL-15, IL-7, IL-6) were found to fall significantly in both groups of therapy. IL-6 and IL-5 levels showed the most significant drop as compared to other cytokines, with a more pronounced decrease in the aflibercept treatment group. In both groups, VEGF-A concentration showed a significant drop, and the share of the eyes that responded to the treatment was 94.7 % in the aflibercept therapy group and 96.2 % in in the dexamethasone implant group.Conclusion. The IOF concentration assessment of a number of pro-inflammatory cytokines/chemokines shows that both the anti-VEGF agent — aflibercept and CS — dexamethasone implant contribute to a decrease of inflammation which is observed 3 months after the start of treatment.

Keywords

• diabetic macular edema
• cytokines
• intraocular fluid
• anti-angiogenic treatment