title: Role of inflammation in previously untreated macular edema with branch retinal vein occlusion.
abstract: BACKGROUND
  The association of inflammatory factors and the aqueous flare value with macular edema in branch retinal vein occlusion (BRVO) patients remains unclear. The relationship between the aqueous flare value and the vitreous fluid levels of vascular endothelial growth factor (VEGF), interleukin (IL)-6, monocyte chemotactic protein (MCP)-1, soluble intercellular adhesion molecule 1 (sICAM-1), and soluble VEGF receptor-2 (sVEGFR-2) was evaluated to investigate the role of inflammation in BRVO associated with macular edema. Aqueous flare values and the vitreous levels of VEGF, IL-6, MCP-1, sICAM-1, and sVEGFR-2 were compared between previously untreated patients with BRVO and patients with macular hole (MH).
  
  
  METHODS
  Vitreous samples were obtained from 45 patients during vitreoretinal surgery (28 patients with BRVO and 17 with MH), and the levels of VEGF, IL-6, MCP-1, sICAM-1, and sVEGFR-2 were measured by enzyme-linked immunosorbent assay. Retinal ischemia was evaluated by measuring the area of capillary non-perfusion using fluorescein angiography and the Scion Image program. Aqueous flare values were measured with a laser flare meter and macular edema was examined by optical coherence tomography.
  
  
  RESULTS
  The median aqueous flare value was significantly higher in the BRVO group (12.1 photon counts/ms) than in the MH group (4.5 photon counts/ms, P < 0.001). There were significant correlations between the aqueous flare value and the vitreous levels of VEGF, IL-6, MCP-1, and sICAM-1 in the BRVO group (ρ = 0.54, P = 0.005; ρ = 0.56, P = 0.004; ρ = 0.52, P = 0.006; and ρ = 0.47, P = 0.015, respectively). The aqueous flare value was also significantly correlated with the foveal thickness in the BRVO group (ρ = 0.40, P = 0.037).
  
  
  CONCLUSIONS
  Inflammation may induce an increase of vascular permeability and disrupt the blood-aqueous barrier via release of inflammatory factors (VEGF, IL-6, MCP-1, and sICAM-1) in BRVO patients with macular edema.
authors.affiliation: Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, 477-96, Owada-shinden, Yachiyo, Chiba, Japan. noma-hide@umin.ac.jp.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Noma
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Mimura
authors.forename: Katsunori
authors.initials: K
authors.lastname: Shimada
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism*; D018932:Chemokine CCL2 / Q000378:metabolism; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000175:diagnosis / Q000378:metabolism*; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008269:Macular Edema / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D012170:Retinal Vein Occlusion / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000378:metabolism; D014821:Vitrectomy; D014822:Vitreous Body / Q000378:metabolism*
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D015850:Interleukin-6; D042461:Vascular Endothelial Growth Factor A; D018799:Intercellular Adhesion Molecule-1; D040301:Vascular Endothelial Growth Factor Receptor-2