Jin Young Kim, Yong Jin Jeong and Sung Pyo Park
Objective: To evaluate the relationship between various cytokine levels in aqueous humor and diabetic macular edema (DME) types as determined by optical coherence tomographic (OCT) patterns.
Methods: The study examined 76 patients with DME at early phase. Ten patients who underwent cataract surgery served as controls. Eyes with DME were divided into four groups, based on OCT patterns of DME, prior to intravitreal bevacizumab injection (IVB). Patterns included sponge-like diffuse retinal thickening (SDRT) (n=27), cystoid macular edema (CME) (n=18), serous retinal detachment (SRD) (n=15), and combined CME and SRD (n=16). Visual acuity, central macular thickness (CMT) through OCT, and aqueous cytokine concentrations of interleukin (IL)-6, IL-8, IL-10, IL-13, monocyte chemo attractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF) were measured in all subjects. The odds ratio (OR) between aqueous cytokines and each DME pattern were calculated using multivariate regression analysis.
Results: After IVB, CMT was reduced in all groups, but the highest reduction ratio occurred in eyes with SDRT and CME. Aqueous analyses showed that VEGF was associated with development of SDRT (P=0.003, OR=1.043, 95% CI=1.015-1.072). IL-6, MCP-1 were related with CME (P<0.001, OR=1.025, 95% CI=1.011-1.039; P<0.001, OR=1.003, 95% CI=1.001-1.004, respectively). IL-6 was also associated with SRD (P=0.045, OR=1.018, 95% CI=1.006-1.030). Furthermore, IL-6, VEGF were related with Combined pattern (P=0.031, OR=1.013, 95% CI=1.002-1.024; P=0.038, OR=1.014, 95% CI=1.014-1.043, respectively).
Conclusion: Specific aqueous cytokines may play an important role in developing each DME pattern based on OCT.