Status of serum VEGF and ICAM-1 and its association with external limiting membrane and inner segment-outer segment junction disruption in type 2 diabetes mellitus.
OBJECTIVE
To correlate the serum levels of vascular endothelial growth factor (VEGF) and intercellular adhesion molecule-1 (ICAM-1) with the severity of retinopathy and disruption of the external limiting membrane (ELM) and inner segment-outer segment (IS-OS) junction in type 2 diabetes mellitus (DM).


METHODS
Study subjects included patients with type 2 DM [diabetes mellitus with no retinopathy (No DR; n=19); non-proliferative diabetic retinopathy (NPDR; n=19); proliferative diabetic retinopathy (PDR; n=20)] and healthy controls (n=19) between the ages of 40 and 65 years. Disruption of the ELM and the IS-OS junction was graded by spectral domain optical coherence tomography as follows: grade 0-no disruption of ELM and IS-OS junction; grade 1-ELM disrupted, inner segment-outer segment (IS-OS) junction intact; grade 2-both ELM and IS-OS junction disrupted. The serum levels of VEGF and ICAM-1were analyzed using the standard protocol.


RESULTS
A significant difference was found between the serum levels of VEGF and ICAM-1 and the various study groups (p<0.001). A positive correlation was found between the grade of disruption and the levels of VEGF (r=0.45, p<0.0001) and ICAM-1 (r=0.40, p=0.0003). A significant positive correlation was found between logMAR visual acuity and grade of disruption (r=0.85, p<0.0001).


CONCLUSIONS
An increase in serum VEGF and ICAM-1 levels is associated with an increase in the severity of diabetic retinopathy and the grade of ELM and IS-OS junction disruption.
Department of Ophthalmology, King George's Medical University, Lucknow, India.
Astha
A
Jain
Sandeep
S
Saxena
Vinay K
VK
Khanna
Rajendra K
RK
Shukla
Carsten H
CH
Meyer
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D055211:Retinal Photoreceptor Cell Inner Segment / Q000378:metabolism*; D055214:Retinal Photoreceptor Cell Outer Segment / Q000378:metabolism*; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*; D014792:Visual Acuity
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D018799:Intercellular Adhesion Molecule-1; D042461:Vascular Endothelial Growth Factor A; C467484:VEGFA protein, human