Prediction of macular edema exacerbation after phacoemulsification in patients with nonproliferative diabetic retinopathy.
OBJECTIVE
To ascertain whether the aqueous humor levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), and protein can predict the postoperative exacerbation of macular edema in patients with nonproliferative diabetic retinopathy (NPDR) after phacoemulsification surgery for cataract.


METHODS
Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.


METHODS
This prospective study included 104 consecutive patients (104 eyes) with NPDR who had cataract surgery. The concentrations of VEGF and IL-6 in aqueous humor specimens obtained during cataract surgery were measured by enzyme-linked immunosorbent assay. Patients were followed for 6 months to assess the postoperative exacerbation of macular edema.


RESULTS
Ninety patients (87%) achieved a visual acuity of 20/40 or better. Exacerbation of macular edema was seen in 30 eyes (29%) after 6 months. Hypertension and the aqueous levels of VEGF, IL-6, and protein were significantly correlated with the exacerbation of macular edema (odds ratio 1.16, 1.33, 1.27, and 1.28, respectively). In contrast, there was no correlation between the exacerbation of macular edema and other systemic factors. Multivariate logistic regression analysis showed that the aqueous VEGF level increase of 100 pg/mL increased the macular edema after phacoemulsification surgery (odds ratio 1.53).


CONCLUSIONS
A high VEGF level in the aqueous humor predicted a significant risk for the postoperative exacerbation of macular edema. A model was developed to predict the risk exacerbation.
Funatsu
Hideharu
H
Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan.
Yamashita
Hidetoshi
H
Noma
Hidetaka
H
Shimizu
Erika
E
Mimura
Tatsuya
T
Hori
Sadao
S
D000368:Aged; D001082:Aqueous Humor / Q000378:metabolism; D002387:Cataract Extraction / Q000009:adverse effects*; D015331:Cohort Studies; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D004487:Edema / Q000503:physiopathology*; D016228:Endothelial Growth Factors / Q000097:blood / Q000378:metabolism; D005260:Female; D005544:Forecasting; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood / Q000378:metabolism; D015850:Interleukin-6 / Q000097:blood / Q000378:metabolism; D019654:Lens Implantation, Intraocular; D008222:Lymphokines / Q000097:blood / Q000378:metabolism; D008266:Macula Lutea; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011446:Prospective Studies; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors
D016228:Endothelial Growth Factors; D036341:Intercellular Signaling Peptides and Proteins; D015850:Interleukin-6; D008222:Lymphokines; D042461:Vascular Endothelial Growth Factor A; D042442:Vascular Endothelial Growth Factors