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Ophthalmology. 2009 Jan;116(1):73-9. doi: 10.1016/j.ophtha.2008.09.037.

Association of vitreous inflammatory factors with diabetic macular edema.

Author information

  • 1Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, Yachiyo, Japan. hfunatsu@tymc.twmu.ac.jp

Abstract

PURPOSE:

To evaluate the association between vitreous inflammatory factors and the severity of diabetic macular edema (DME).

DESIGN:

Retrospective case-control study.

PARTICIPANTS:

Fifty-three patients with DME, 15 patients with nondiabetic ocular disease, and 8 diabetic patients without retinopathy.

METHODS:

Vitreous fluid samples were obtained during vitreoretinal surgery, and the levels of vascular endothelial growth factor (VEGF), intercellular adhesion molecule (ICAM)-1, interleukin (IL)-6, monocyte chemotactic protein (MCP)-1, and pigment epithelium-derived factor (PEDF) were measured by enzyme-linked immunosorbent assay. Multivariate analysis was performed to assess the association of these factors with the severity of DME.

MAIN OUTCOME MEASURES:

Vitreous fluid levels of inflammatory factors.

RESULTS:

Vitreous fluid levels of VEGF, ICAM-1, IL-6, and MCP-1 were significantly higher in patients with DME than in nondiabetic patients (P<0.05, all respectively) or diabetic patients without retinopathy (P<0.05, all respectively). In contrast, the PEDF level was significantly lower in patients with DME than in nondiabetic patients (P<0.05) or diabetic patients without retinopathy (P<0.05). Vitreous levels of VEGF, ICAM-1, IL-6, and MCP-1 were significantly higher in patients with hyperfluorescent DME than in those with minimally fluorescent DME (P = 0.0018, P = 0.0022, P = 0.0032, and P = 0.0053, respectively). Conversely, the vitreous level of PEDF was significantly lower in hyperfluorescent DME than in minimally fluorescent DME (P = 0.0134). Vitreous levels of VEGF, ICAM-1, IL-6, MCP-1, and PEDF were significantly correlated with the retinal thickness at the central fovea (P<0.0001, P<0.0001, P = 0.0282, P = 0.0009, and P = 0.0466, respectively). VEGF and ICAM-1 had a stronger influence on the severity of DME than the other factors (P = 0.0004 and P = 0.0372, respectively).

CONCLUSIONS:

Vitreous fluid levels of VEGF, ICAM-1, IL-6, MCP-1, and PEDF were related to retinal vascular permeability and the severity of DME. VEGF and ICAM-1 had a stronger influence than the other factors.

FINANCIAL DISCLOSURE(S):

The authors have no proprietary or commercial interest in any materials discussed in this article.

PMID:
19118698
[PubMed - indexed for MEDLINE]
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