title: Effect of intravitreal dexamethasone implant on intra-ocular cytokines and chemokines in eyes with retinal vein occlusion.
abstract: OBJECTIVE
  To investigate the influence of intravitreal dexamethasone implant on inflammatory and angiogenic cytokine levels in the aqueous of patients with retinal vein occlusion (RVO).
  
  
  METHODS
  Forty eyes of 40 consecutive patients with macular oedema (ME) due to branch and central retinal vein occlusion (BRVO/CRVO) were treated with an intravitreal dexamethasone implant (Ozurdex®) at baseline and evaluated until month 6. Retreatment was performed in case of recurrent ME earliest 4 months after the baseline treatment. Aqueous humour samples were taken at baseline, months 1, 3, 6 and at the time of each retreatment. Concentrations of 29 different cytokines were measured by Luminex®bead assays. The control group comprised healthy patients undergoing cataract surgery.
  
  
  RESULTS
  At baseline concentrations of interleukin (IL)-8, angiopoietin (ANG)-2 and intercellular adhesion molecule (ICAM)-1 were highly elevated in patients with CRVO compared with controls (p = 0.006; p = 0.02; p = 0.03). Vascular endothelial growth factor (VEGF) concentrations were upregulated in patients with BRVO and CRVO (p = 0.003; p = 0.001). Retreatment with a dexamethasone implant was necessary after 4 months in 14/8 (BRVO/CRVO) patients, 5 months in 5/3 patients and 6 months in one patient (BRVO). After the initial treatment, macrophage chemo-attractant protein (MCP)-1 and IL17-E concentrations decreased in BRVO (p < 0.001; p = 0.01) and MCP-1 and IL1-α in CRVO (p = 0.01; p = 0.003). Vascular endothelial growth factor (VEGF) concentrations did not change during treatment in either group (p = 0.3). A mixed-effect model showed that cytokine concentrations positively correlated with central retinal thickness changes.
  
  
  CONCLUSIONS
  Intravitreal dexamethasone treatment resulted in alterations in the concentrations of pro-inflammatory cytokines MCP-1 and IL17-E in patients with BRVO and MCP-1 and IL1-α in patients with CRVO. These data highlight the important role of inflammatory mediators involved in ME due to RVO.
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Sandra
authors.initials: S
authors.lastname: Rezar-Dreindl
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Katharina
authors.initials: K
authors.lastname: Eibenberger
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Pollreisz
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Wolf
authors.initials: W
authors.lastname: Bühl
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Georgopoulos
authors.affiliation: Department of Medical Statistics, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Krall
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Roman
authors.initials: R
authors.lastname: Dunavölgyi
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Günther
authors.initials: G
authors.lastname: Weigert
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Maria-Elisabeth
authors.initials: ME
authors.lastname: Kroh
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Ursula
authors.initials: U
authors.lastname: Schmidt-Erfurth
authors.affiliation: Department of Ophthalmology, Medical University of Vienna, Vienna, VIE, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sacu
mesh_terms: D000368:Aged; D001082:Aqueous Humor / Q000737:chemistry*; D018925:Chemokines / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism*; D003907:Dexamethasone / Q000008:administration & dosage*; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects*
chemical_list: D018925:Chemokines; D016207:Cytokines; D004343:Drug Implants; D005938:Glucocorticoids; D003907:Dexamethasone
keywords: branch retinal vein occlusion; central retinal vein occlusion; dexamethasone intravitreal implant; intra-ocular cytokines