The Intraocular Cytokine Profile and Therapeutic Response in Persistent Neovascular Age-Related Macular Degeneration

Autor: Christoph Krall, Andreas Pollreisz, Günther Weigert, Sandra Rezar-Dreindl, Michael Georgopoulos, Wolf Bühl, Stefan Sacu, Ursula Schmidt-Erfurth, Katharina Eibenberger
Rok vydání: 2016
Předmět:
0301 basic medicine
Male
Time Factors
genetic structures
medicine.medical_treatment
Visual Acuity
Angiogenesis Inhibitors
Retinal Neovascularization
Gastroenterology
Dexamethasone
chemistry.chemical_compound
Macular Degeneration
0302 clinical medicine
Prospective Studies
Fluorescein Angiography
Drug Implants
biology
Vascular endothelial growth factor
Monokine
Cytokine
Treatment Outcome
Intravitreal Injections
Cytokines
Drug Therapy
Combination
Female
Tomography
Optical Coherence
medicine.drug
medicine.medical_specialty
Fundus Oculi
Aqueous Humor
03 medical and health sciences
Internal medicine
Ophthalmology
Ranibizumab
medicine
Humans
Interleukin 6
Macular edema
Glucocorticoids
Aged
Dose-Response Relationship
Drug
business.industry
Macular degeneration
medicine.disease
030104 developmental biology
chemistry
030221 ophthalmology & optometry
biology.protein
business
Follow-Up Studies
Zdroj: Investigative ophthalmologyvisual science. 57(10)
ISSN: 1552-5783
Popis: Purpose To investigate the course of inflammatory and angiogenic cytokines in the aqueous humor of patients with persistent/recurrent neovascular age-related macular degeneration (nAMD) under ranibizumab monotherapy (IVM) or ranibizumab plus dexamethasone combination treatment. Methods In this 12-month prospective study, 40 eyes with nAMD were treated with either IVM or combined treatment with ranibizumab plus intravitreal dexamethasone implant (IVC). Patients in the IVM group were treated following an "as needed" treatment regimen; patients in the IVC group received ranibizumab and a dexamethasone implant at baseline and were re-treated with ranibizumab. At baseline and at each time of retreatment aqueous humor samples were taken. Results Before treatment, levels of macrophage chemoattractant protein (MCP)-1, monokine induced by γ interferon (MIG), and lipocalin-2/ neutrophil gelatinase-associated lipocalin (NGAL) were elevated in nAMD patients compared to healthy controls (P = 0.024; P = 0.04; P = 0.01). In contrast, tumor necrosis factor α, IL-12p70, and secreted protein acidic and rich in cysteine (SPARC) concentrations were lower (P = 0.001; P = 0.008; P = 0.03), while vascular endothelial growth factor (VEGF) was not altered (45 ± 6/51 ± 12 pg/mL nAMD/control group; P = 0.6). During IVC, levels of VEGF, MIG, platelet-derived growth factor (PDGF)-AA, and transforming growth factor β1 (P = 0.005; P = 0.011; P = 0.008; P = 0.013) were reduced. Ranibizumab monotherapy did not influence the course of any inflammatory/angiogenic cytokine. Interleukin 6 and PDGF-AA levels correlated with central retinal thickness changes (P = 0.007; P = 0.022). Over the 12-month period visual function was maintained with no significant differences during or between both treatment groups. Conclusions Inflammatory proteins are involved in the pathogenesis of chronic macular edema due to AMD and are associated with disease activity. During combined treatment, levels of inflammatory and angiogenic cytokines decreased over a 12-month period with no superiority in functional outcome.
Databáze: OpenAIRE
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