Visual prognosis and vitreous cytokine levels after arteriovenous sheathotomy in branch retinal vein occlusion associated with macular oedema.
OBJECTIVE
To investigate the relationship between vitreous levels of cytokines, including interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF), and visual prognosis after pars plana vitrectomy (PPV) with arteriovenous sheathotomy in patients with branch retinal vein occlusion (BRVO) associated with macular oedema.


METHODS
We studied 60 patients with logMAR visual acuity (VA) scores of < 0.3 and visual impairment secondary to BRVO-associated macular oedema. All patients underwent PPV with arteriovenous sheathotomy. At the time of PPV, vitreous samples were collected from the operated eye and vitreous levels of VEGF and IL-6 were measured. Best corrected VA (BCVA) (using a logMAR chart) and foveal thickness (FT) (using optical coherence tomography) were monitored for up to 6 months after PPV.


RESULTS
Both BCVA and FT significantly improved after PPV. According to multiple regression analysis, both the improvement in BCVA and decrease in FT were closely related to the vitreous level of IL-6 but not to that of VEGF. The vitreous level of VEGF was strongly correlated with duration of BRVO.


CONCLUSIONS
Both improvement in BCVA and decrease in FT were observed after PPV in BRVO patients with macular oedema. Interestingly, these visual prognoses strongly correlate with the vitreous level of IL-6, whereas the duration of BRVO strongly correlates with the vitreous level of VEGF.
Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Japan. masahiko@oph.med.tohoku.ac.jp
Masahiko
M
Shimura
Toru
T
Nakazawa
Kanako
K
Yasuda
Hiroshi
H
Kunikata
Takashi
T
Shiono
Kohji
K
Nishida
D000368:Aged; D003238:Connective Tissue / Q000601:surgery; D019299:Decompression, Surgical; D005260:Female; D005584:Fovea Centralis / Q000473:pathology; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D008269:Macular Edema / Q000150:complications / Q000276:immunology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012169:Retinal Vein; D012170:Retinal Vein Occlusion / Q000209:etiology / Q000276:immunology / Q000601:surgery*; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D015354:Vision, Low / Q000209:etiology / Q000276:immunology / Q000601:surgery; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000276:immunology / Q000378:metabolism*
D015850:Interleukin-6; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A