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


METHODS
Retrospective case-control study.


METHODS
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.


METHODS
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.


BACKGROUND
The authors have no proprietary or commercial interest in any materials discussed in this article.
Funatsu
Hideharu
H
Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, Yachiyo, Japan. hfunatsu@tymc.twmu.ac.jp
Noma
Hidetaka
H
Mimura
Tatsuya
T
Eguchi
Shuichiro
S
Hori
Sadao
S
D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000378:metabolism; D003930:Diabetic Retinopathy / Q000378:metabolism*; D004797:Enzyme-Linked Immunosorbent Assay; D005136:Eye Proteins / Q000378:metabolism; D005260:Female; D005451:Fluorescein Angiography; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D017075:Laser Coagulation; D008269:Macular Edema / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000378:metabolism; D012189:Retrospective Studies; D015843:Serpins / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D014822:Vitreous Body / Q000378:metabolism*; D000099174:Pigment Epithelium-Derived Factor
D018932:Chemokine CCL2; D005136:Eye Proteins; D006442:Glycated Hemoglobin; D018836:Inflammation Mediators; D018799:Intercellular Adhesion Molecule-1; D015850:Interleukin-6; D009414:Nerve Growth Factors; D015843:Serpins; D042461:Vascular Endothelial Growth Factor A; D000099174:Pigment Epithelium-Derived Factor; C111835:CCL2 protein, human; C508600:IL6 protein, human; C467484:VEGFA protein, human