Risk evaluation of outcome of vitreous surgery based on vitreous levels of cytokines.
OBJECTIVE
To ascertain whether vitreous and plasma levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) and fundus findings could predict the outcome of vitreous surgery in patients with proliferative diabetic retinopathy (PDR).


METHODS
Vitreous fluid samples were obtained during vitreoretinal surgery from 73 consecutive eyes with PDR. The levels of VEGF and IL-6 in vitreous fluid and plasma were determined by enzyme-linked immunosorbent assay. Patients were prospectively followed for 6 months and the postoperative outcome was analysed by logistic regression analysis.


RESULTS
No improvement and/or progression of PDR occurred in 23 (32%) of the 73 eyes (progression group). The vitreous levels of VEGF and IL-6 were significantly higher in eyes from the progression group than in eyes with regression of PDR (regression group) (P=0.0032 and 0.0088, respectively). Multivariate logistic regression analysis showed that higher vitreous levels of VEGF were associated with the progression of PDR after vitreous surgery (odds ratio 2.72, P=0.0003).


CONCLUSIONS
High vitreous levels of VEGF identified as a significant risk factor for the outcome of vitreous surgery in patients with PDR. A model was developed to predict the probability of PDR progression and measurement of the vitreous level of VEGF may be useful for predicting the outcome of surgery.
Funatsu
H
H
Department of Ophthalmology, Diabetes Center, Tokyo Women's Medical University, Tokyo, Japan. tfunatsu@ nifty.com
Yamashita
H
H
Mimura
T
T
Noma
H
H
Nakamura
S
S
Hori
S
S
D000328:Adult; D000368:Aged; D003930:Diabetic Retinopathy / Q000097:blood / Q000378:metabolism / Q000601:surgery*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000032:analysis* / Q000097:blood; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000150:complications / Q000378:metabolism; D015861:Retinal Neovascularization / Q000150:complications / Q000378:metabolism; D018570:Risk Assessment / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis* / Q000097:blood; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body / Q000737:chemistry*; D014823:Vitreous Hemorrhage / Q000150:complications / Q000378:metabolism
D015850:Interleukin-6; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A