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Noma H, Yasuda K, Nonaka R, Sasaki S, Shimura M. Anti-Vascular Endothelial Growth Factor Therapy with or Without Initial Steroid Therapy for Macular Edema in Branch Retinal Vein Occlusion. Clin Ophthalmol 2023; 17:2267-2275. [PMID: 37581097 PMCID: PMC10423566 DOI: 10.2147/opth.s418843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/20/2023] [Indexed: 08/16/2023] Open
Abstract
Purpose In branch retinal vein occlusion (BRVO), administering steroid injections to inhibit expression of inflammatory factors in the first phase of macular edema may reduce recurrence of the edema. The purpose of our study was to investigate the functional and morphological prognosis and frequency of recurrence after injection of an anti-vascular endothelial growth factor (VEGF) with and without initial steroid therapy to treat macular edema with BRVO. Patients and Methods Patients with BRVO and macular edema (41 eyes) received intravitreal ranibizumab injection (IRI) alone (IRI group, 21 eyes) or subtenon triamcinolone (STTA) injection and IRI (combination group, 20 eyes). Patients in both groups with recurrent macular edema received further IRI as appropriate. A laser flare meter was used to assess aqueous flare values, and an optical coherence tomography device was used to measure central macular thickness (CMT). Before the first treatment, we obtained samples of aqueous humor and analyzed them by the suspension array method to evaluate VEGF, placental growth factor (PlGF), platelet-derived growth factor (PDGF)-AA, soluble intercellular adhesion molecule (sICAM)-1, monocyte chemoattractant protein 1 (MCP-1), interleukin (IL)-6, IL-8, and interferon-inducible 10-kDa protein (IP-10). Results The two groups were not significantly different with regard to levels of VEGF, PlGF, PDGF-AA, sICAM-1, MCP-1, IL-6, IL-8, or IP-10. Best-corrected visual acuity, CMT, and aqueous flare value (IRI group, baseline 8.69 ± 4.55 photon counts/ms; combination group, baseline 9.21 ± 3.72 photon counts/ms) improved significantly in both groups without significant intergroup differences. Analyses showed no significant intergroup differences in the mean number of IRIs during the 12-month follow-up, but the proportion of patients without recurrence (ie, who received only one IRI) was significantly higher in the combination group than in the IRI group (P = 0.032). Furthermore, the time to initial recurrence was significantly longer in the combination group than in the IRI group (P = 0.003). Conclusion These findings suggest that initial STTA injection and IRI may have a synergistic effect in patients with BRVO and macular edema in that they increase the time between anti-VEGF treatments.
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Affiliation(s)
- Hidetaka Noma
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Kanako Yasuda
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Ryota Nonaka
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Shotaro Sasaki
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Masahiko Shimura
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
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Yasuda K, Noma H, Oyama E, Yanagida K, Asakage M, Shimura M. Effects of Intravitreal Ranibizumab Injection to Treat Macular Edema due to Central Retinal Vein Occlusion on Choroidal Findings and Functional-Morphological Parameters. Ophthalmic Res 2023; 66:1063-1070. [PMID: 37331343 PMCID: PMC10614477 DOI: 10.1159/000531498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/05/2023] [Indexed: 06/20/2023]
Abstract
INTRODUCTION Little research has examined the effects of anti-vascular endothelial growth factor therapy on subfoveal choroidal thickness (SCT), choroidal blood flow, aqueous flare, and humor levels of growth and inflammatory factors in patients with macular edema due to central retinal vein occlusion (CRVO). METHODS In 58 patients with macular edema due to CRVO treated by intravitreal ranibizumab injection (IRI), we retrospectively assessed best-corrected visual acuity (BCVA, assessed as the logarithm of the minimum angle of resolution [logMAR]), 8 aqueous factors (by suspension array), mean blur rate (MBR; estimated by laser speckle flowgraphy as a measure of choroidal blood flow), aqueous flare (with a laser flare meter), and SCT and central macular thickness (CMT; by optical coherence tomography). RESULTS After 4 weeks, IRI resulted in a significant improvement in BCVA and CMT and a significant reduction in SCT, choroidal MBR, and aqueous flare. SCT was significantly positively correlated with placental growth factor and significantly negatively correlated with platelet-derived growth factor-AA, and change in SCT was significantly negatively correlated with change in BCVA (logMAR). Aqueous flare was significantly negatively correlated with SCT. CONCLUSION Growth and inflammatory factors may be associated with SCT, and changes in SCT may be associated with changes in BCVA after IRI to treat macular edema due to CRVO.
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Affiliation(s)
- Kanako Yasuda
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Hidetaka Noma
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Eri Oyama
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Kosei Yanagida
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Masaki Asakage
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | - Masahiko Shimura
- Department of Ophthalmology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
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Wang B, Zhang X, Chen H, Koh A, Zhao C, Chen Y. A Review of Intraocular Biomolecules in Retinal Vein Occlusion: Toward Potential Biomarkers for Companion Diagnostics. Front Pharmacol 2022; 13:859951. [PMID: 35559255 PMCID: PMC9086509 DOI: 10.3389/fphar.2022.859951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/25/2022] [Indexed: 12/04/2022] Open
Abstract
Retinal vein occlusion (RVO) is one of the most common retinal vascular diseases. The pathogenesis of RVO is multifactorial and involves a complex interplay among a variety of vascular and inflammatory mediators. Many cytokines, chemokines, growth factors, and cell adhesion molecules have been reported to be implicated. Treatments for RVO are directed at the management of underlying risk factors and vision-threatening complications, including macula edema (ME) and neovascularization. Intravitreal anti-VEGF agents are currently considered as the first-line treatment for ME secondary to RVO (RVO-ME), but a substantial proportion of patients responded insufficiently to anti-VEGF agents. Since RVO-ME refractory to anti-VEGF agents generally responds to corticosteroids and its visual outcome is negatively correlated to disease duration, prediction of treatment response at baseline in RVO-ME may significantly improve both cost-effectiveness and visual prognosis. Several bioactive molecules in the aqueous humor were found to be associated with disease status in RVO. This review aims to present a comprehensive review of intraocular biomolecules reported in RVO, including VEGF, IL-6, IL-8, MCP-1, sICAM-1, IL-12, IL-13, sVEGFR-1, sVEGFR-2, PDGF-AA, etc., highlighting their association with disease severity and/or phenotype, and their potential roles in prognostic prediction and treatment selection. Some of these molecules may serve as biomarkers for aqueous humor-based companion diagnostics for the treatment of RVO in the future.
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Affiliation(s)
- Bingjie Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- School of Medicine, Tsinghua University, Beijing, China
| | - Xiao Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huan Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Adrian Koh
- Eye & Retina Surgeons, Camden Medical Centre, Singapore, Singapore
| | - Chan Zhao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Youxin Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
- Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wu L, Acon D, Berrocal MH, Gallego-Pinazo R, Dolz-Marco R, Roca JA, Maia M, Rojas S, Zas M, Arevalo JF, Chhablani J. Five-year outcomes after intravitreal bevacizumab of treatment-naive eyes with macular edema secondary to CRVO in routine clinical practice: Results of the Pan-American Collaborative Retina Study (PACORES) group. Int Ophthalmol 2021; 42:951-958. [PMID: 34628544 DOI: 10.1007/s10792-021-02077-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 09/29/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to report the 5-year outcomes of treatment-naive eyes with cystoid macular edema secondary to central retinal vein occlusion treated with intravitreal bevacizumab in routine clinical practice. METHODS We conducted multicenter retrospective non-comparative case series of 102 eyes. The main outcome measured was the change in best-corrected visual acuity (BCVA) at 5 years. Secondary outcomes included the number of injections and the change in CMT at 5 years. RESULTS At 5 years, the mean BCVA improved from 1.22 ± 0.58 (Snellen 20/428) at baseline to 1.00 ± 0.68 logMAR (Snellen 20/200; p < 0.0001). At 5 years, 48 (47%) eyes had a gain of ≥ 3 lines, 41 (40.2%) eyes remained within 3 lines and 13 (12.7%) eyes had a loss of ≥ 3 lines of BCVA. The CMT improved from 740 ± 243 to 322 ± 179 µm (p < 0.0001). At 5 years, 59 (57.8%) eyes had a completely dry SD-OCT. Patients received a total of 10.6 ± 6.1 (range 6-27) injections. Baseline BCVA (p < 0.0001) and the duration of symptoms prior to initial anti-VEGF injection (p = 0.0274) were the only predictive factors for BCVA at 5 years. CONCLUSIONS After 5 years with an average of 10.6 injections, there was a mean gain of 0.22 logMAR. In addition, more eyes achieved a BCVA of ≥ 20/40, gained ≥ 3 lines and less patients had a BCVA ≤ 20/200. Eyes with a better baseline BCVA and a shorter duration of symptoms were more likely to achieve better BCVA at 5 years.
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Affiliation(s)
- Lihteh Wu
- Asociados de Macula Vitreo y Retina de Costa Rica, Primer Piso, Torre Mercedes, Paseo Colón, San José, Costa Rica. .,Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois Chicago School of Medicine, Chicago, IL, USA.
| | - Dhariana Acon
- Asociados de Macula Vitreo y Retina de Costa Rica, Primer Piso, Torre Mercedes, Paseo Colón, San José, Costa Rica
| | - Maria H Berrocal
- Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico
| | | | | | | | - Mauricio Maia
- Department of Ophthalmology, Vision Institute, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Sergio Rojas
- Fundación Hospital Nuestra Señora de la Luz, Mexico City, Mexico
| | - Marcelo Zas
- Department of Ophthalmology, University of Buenos Aires, Buenos Aires, Argentina
| | - J F Arevalo
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Jay Chhablani
- L.V.Prasad Eye Institute, Hyderabad, India.,Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
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Hübnerová P, Mlčák P, Šínová I, Karhanová M, Šín M. Current use of the automatic retinal oximetry. Review. CESKÁ A SLOVENSKÁ OFTALMOLOGIE : CASOPIS CESKÉ OFTALMOLOGICKÉ SPOLECNOSTI A SLOVENSKÉ OFTALMOLOGICKÉ SPOLECNOSTI 2020; 76:3-11. [PMID: 32917089 DOI: 10.31348/2020/1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE To inform about possible use of the automatic retinal oximetry for the retinal oxygen saturation measurement in the eye and systemic diseases. METHODS We performed a literature review dealing with issues of retinal oxygen saturation monitoring by dual non-invasive retinal oximetry Oxymap T1 (Oxymap ehf. Reykjavík, Iceland). RESULTS We have found two main strains writing our paper on retinal oxygen saturation eye diseases. The first section concerns diseases created by having hypoxia as its main pathological factor - for example diabetes mellitus and retinal vein occlusion. The second group deals with atrophy as the main pathological mechanism which is typical for decreasing retinal oxygen consumption - for example glaucoma or retinitis pigmentosa (the second one named is not included in our work). Oximetry in systemic diseases creates a relatively new chapter of this branch with a very big potential of interdisciplinary cooperation for the future. It is possible the cooperation will not only include diabetologists but also neurologists (for example, in diseases like sclerosis multiplex or Devics, Alzheimers and Parkinsons disease) and haematologists (retinal oxygen saturation changes in patients with different rheological attributes of blood). CONCLUSION Retinal oxygen saturation measuring by automatic retinal oximetry is a relatively new method with scientifically confirmed high reproducibility of results. Currently it is the only experimental method with vast potentials not only in the realm of the possibility of observing eye diseases (diabetic retinopathy, retinal vein occlusion or glaucoma) but also in developing interdisciplinary cooperation with diabetologists, neurologists and haematologists.
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Tan CS, Li KZ, Sadda SR. Wide-field angiography in retinal vein occlusions. Int J Retina Vitreous 2019; 5:18. [PMID: 31890282 PMCID: PMC6907103 DOI: 10.1186/s40942-019-0163-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 04/09/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Retinal vein occlusion (RVO) is the second most common retinal vascular disease after diabetic retinopathy. It can result in significant visual loss from complications like macula edema, retinal and iris neovascularization, and vitreous hemorrhage. Recently, ultra-widefield imaging (UWF) has been developed for posterior pole visualization and has shown to be useful in the evaluation and treatment of RVO. MAIN TEXT Ultra-widefield imaging (UWF) imaging allows for visualization of the retina up to an angle of 200°. This is especially important in detecting peripheral retinal pathologies, especially in retinal conditions such as RVO, where the disease process affects the peripheral as well as central retina. In particular, retinal non-perfusion in RVO is a risk factor for neovascularization. Various techniques, such as ischemic index and stereographic projection, have been described to assess areas of ischemia on UWF images. Retinal non-perfusion has an impact on disease complications, such as macular edema, and retinal and iris neovascularization. Retinal non-perfusion also has implications on disease response, including visual acuity, reduction in retinal edema and treatment burden. CONCLUSION Ultra-widefield imaging (UWF) imaging plays an important role in the assessment and management of RVO, especially in measuring retinal non-perfusion in the peripheries.
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Affiliation(s)
- Colin S. Tan
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Jalan Tan Tock Seng, 11, Singapore, 308433 Singapore
- Fundus Image Reading Center, National Healthcare Group Eye Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Kelvin Z. Li
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Jalan Tan Tock Seng, 11, Singapore, 308433 Singapore
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Minaker SA, Mason RH, Bamakrid M, Lee Y, Muni RH. Changes in Aqueous and Vitreous Inflammatory Cytokine Levels in Retinal Vein Occlusion: A Systematic Review and Meta-analysis. ACTA ACUST UNITED AC 2019; 4:36-64. [PMID: 37009560 PMCID: PMC9976078 DOI: 10.1177/2474126419880391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: Evidence suggests that inflammatory cytokines not only play a role in the pathogenesis of retinal vein occlusion (RVO) but also may be useful as biomarkers to predict disease severity and response to treatment. We aimed to quantitatively summarize data on inflammatory cytokines associated with RVO. Methods: A systematic search of peer-reviewed English-language articles was performed without year limitation up to August 19, 2019. Studies were included if they provided data on aqueous or vitreous cytokine concentrations in patients with RVO. Data were extracted from 116 studies that encompassed 3242 study eyes with RVO and 1402 control eyes. Effect sizes were generated as standardized mean differences (SMDs) of cytokine concentrations between patients with RVO vs controls. Results: Among the 4644 eyes in 116 studies, aqueous and vitreous concentrations (SMD, 95% CI, and P value) of interleukin (IL)-6 (aqueous: 1.23, 0.65 to 1.81, P < .001 vitreous: 0.70, 0.49 to 0.90, P < .001), IL-8 (aqueous: 1.11, 0.73 to 1.49, P < .001; vitreous: 1.19, 0.73 to 1.65, P < .001), monocyte chemoattractant protein 1(aqueous: 1.22, 0.72 to 1.72, P < .001; vitreous 1.42, 0.92 to 1.91, P < .001), vascular endothelial growth factor (VEGF) (aqueous: 1.52, 1.09 to 1.94, P < .001; vitreous: 0.99, 0.78 to 1.21, P < .001) were significantly higher in patients with RVO than in healthy controls. Only aqueous concentrations of IL-10 (0.81, 0.45 to 1.18, P < .001), angiopoietin 4 (1.96, 0.92 to 3.00, P < .001), and platelet-derived growth factor (PDGF)-AA (0.82, 0.35 to 1.30, P < .001) were significantly higher in patients with RVO than in healthy controls. Only the vitreous concentration of soluble intercellular adhesion molecule-1 (sICAM-1) (1.23, 0.83 to 1.63, P < .001) was significantly higher in patients with RVO. No differences, failed sensitivity analyses, or insufficient data were found between patients with RVO and healthy controls for the concentrations of the remaining cytokines. Conclusions: Several cytokines in addition to VEGF have the potential to be useful biomarkers and therapeutic targets in RVO.
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Affiliation(s)
- Samuel A. Minaker
- Department of Ophthalmology, St Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Center, Toronto, Ontario, Canada
| | - Ryan H. Mason
- Department of Ophthalmology, St Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Center, Toronto, Ontario, Canada
| | - Motaz Bamakrid
- Department of Ophthalmology, St Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Center, Toronto, Ontario, Canada
| | - Yung Lee
- Department of Ophthalmology, St Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Rajeev H. Muni
- Department of Ophthalmology, St Michael’s Hospital/Unity Health Toronto, Toronto, Ontario, Canada
- Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Kensington Vision and Research Center, Toronto, Ontario, Canada
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Hall L, Frizzera LP, Coelho LF, Carricondo PC, Oyamada MK, Pimentel SLG, Abalem MF. Prospective evaluation of intravitreal bevacizumab for ischemic central retinal vein occlusion. Int J Retina Vitreous 2019; 5:32. [PMID: 31372240 PMCID: PMC6659291 DOI: 10.1186/s40942-019-0183-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/17/2019] [Indexed: 11/24/2022] Open
Abstract
Background Although previous studies have evaluated the effect of anti-VEGF therapies for central retinal vein occlusion (CRVO) patients, the majority of previous studies have excluded or included a very small number of patients with ischemic CRVO (iCRVO). The aim of our study is to examine the effects of bevacizumab on macular edema secondary to ischemic central retinal vein occlusion, as well as the effects on central choroidal thickness and best-corrected visual acuity. Methods In this prospective, interventional case series, iCRVO was defined by the presence of ≥ 10 or more disc diameter areas of retinal nonperfusion by fluorescein angiography (FA) and by the presence of a b/a ratio less than 1.5 by full-field electroretinogram (ffERG). Nine eyes with iCRVO received monthly bevacizumab 0.5 mg injections at baseline and months 1 to 5 for a maximum of six injections. Main outcome measures were visual acuity (Snellen), central foveal thickness, and central choroidal thickness as measured by Spectral-Domain Optical Coherence Tomography (SD-OCT) at baseline and at 6 month following initial intravitreal bevacizumab injection. Pairwise t-tests and the Wilcoxon signed-rank test were conducted to compare the outcome measures. Results After intravitreal administration of bevacizumab, there was a significant reduction of central foveal thickness from 858 ± 311 μm at baseline to 243 ± 106 μm at the 6-month follow-up, as well as a significant reduction of central choroidal thickness from 282 ± 38 μm at baseline to 227 ± 56 μm at the 6-month follow-up (p = 0.0006, p = 0.0003 respectively). The visual acuity worsened from a median of 1.3 to 1.7 (p = 0.02). Conclusion In patients with iCRVO, intravitreal bevacizumab led to a reduction of central macular edema and central choroidal thickness, but a worsening of visual acuity. Intravitreal bevacizumab reduces macular edema but is not able to overcome the poor prognosis of iCRVO.
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Affiliation(s)
| | - Luma Paiva Frizzera
- 2Department of Ophthalmology and Otolaryngology, University of Sao Paulo Medical School, São Paulo, Sao Paulo Brazil
| | - Laura Fernandes Coelho
- 2Department of Ophthalmology and Otolaryngology, University of Sao Paulo Medical School, São Paulo, Sao Paulo Brazil
| | - Pedro Carlos Carricondo
- 2Department of Ophthalmology and Otolaryngology, University of Sao Paulo Medical School, São Paulo, Sao Paulo Brazil
| | - Maria Kiyoko Oyamada
- 2Department of Ophthalmology and Otolaryngology, University of Sao Paulo Medical School, São Paulo, Sao Paulo Brazil
| | - Sergio Luis Gianotti Pimentel
- 2Department of Ophthalmology and Otolaryngology, University of Sao Paulo Medical School, São Paulo, Sao Paulo Brazil
| | - Maria Fernanda Abalem
- 2Department of Ophthalmology and Otolaryngology, University of Sao Paulo Medical School, São Paulo, Sao Paulo Brazil.,3Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48150 USA
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Khayat M, Williams M, Lois N. Ischemic retinal vein occlusion: characterizing the more severe spectrum of retinal vein occlusion. Surv Ophthalmol 2018; 63:816-850. [DOI: 10.1016/j.survophthal.2018.04.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 04/14/2018] [Accepted: 04/20/2018] [Indexed: 12/15/2022]
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Abstract
PURPOSE To analyze the levels of lysophosphatidic acids (LPAs) and autotaxin (ATX) in undiluted vitreous of untreated patients with retinal vein occlusion (RVO). METHODS Sixty-four vitreous samples (40 RVO, 24 controls with idiopathic floaters) were analyzed in this retrospective case series using LC/MS for LPAs 16:0, 18:0, 18:1, 20:4, and ELISA kits or Luminex technology for ATX, angiopoetin-1 (ANG-1), interleukin-6 (IL-6), interleukin-7 (IL-7), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), pigment epithelium-derived factor (PEDF), and vascular endothelial growth factor (VEGF). LPA and ATX levels were correlated with the visual acuity, central macular thickness (CMT), average retinal thickness (AvT), vitreal cytokine levels and with each other. RESULTS Levels of every LPA species tested and ATX were significantly increased in the vitreous fluid from all patients with RVO (total LPAs: 968.0 ± 842.3 nM; ATX: 2.5 ± 1.02 nM) compared with controls (total LPAs: 225.2 ± 292.8 nM, P < 0.0001; ATX: 1.9 ± 1.00 nM, P = 0.005). There were strong positive correlations between the vitreal levels of IL-6, IL-8, MCP-1, VEGF and LPAs. CONCLUSION Levels of LPAs and ATX were positively correlated with proinflammatory cytokines and VEGF and might thus play an important role in the development of macular edema secondary to RVO.
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Ghodasra DH, Fante R, Gardner TW, Langue M, Niziol LM, Besirli C, Cohen SR, Dedania VS, Demirci H, Jain N, Jayasundera KT, Johnson MW, Kalyani PS, Rao RC, Zacks DN, Sundstrom JM. Safety and Feasibility of Quantitative Multiplexed Cytokine Analysis From Office-Based Vitreous Aspiration. Invest Ophthalmol Vis Sci 2017; 57:3017-23. [PMID: 27273720 PMCID: PMC4904801 DOI: 10.1167/iovs.15-18721] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The goals of this study were to evaluate the safety of office-based vitreous sampling, and determine the utility of these samples with multiplex cytokine analysis. Methods Vitreous samples were collected from office-based needle aspiration and the rate of adverse events during follow-up was reviewed. The vitreous cytokine concentrations in a subset of patients with diabetic macular edema (DME) were analyzed using a 42 plex-cytokine bead array. These results were compared with vitreous cytokine concentrations in proliferative diabetic retinopathy (PDR) and controls (macular hole, epiretinal membrane, symptomatic vitreous floaters) from pars plana vitrectomy. Results An adequate volume of vitreous fluid (100–200 μL) was obtained in 52 (88%) of 59 office-based sampling attempts. The average length of follow-up was 300 days (range, 42–926 days). There were no complications, including cataract, retinal tear or detachment, and endophthalmitis. Two patients (3%) had posterior vitreous detachments within 3 months. Vitreous cytokine concentrations were measured in 44 patients: 14 controls, 13 with DME, and 17 with PDR. The concentration of ADAM11, CXCL-10, IL-8, and PDGF-A were higher in PDR compared with controls and DME. The concentration of IL-6 was higher in PDR compared with controls, but not compared with DME. Conclusions Office-based vitreous aspiration is safe and yields high-quality samples for multiplex vitreous cytokine analysis. Significant elevations of vitreous cytokines were found in PDR compared with DME and controls, including the novel finding of elevated ADAM11. As such, office-based aspiration is a safe and effective means to identify vitreous factors associated with vitreoretinal disease.
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Affiliation(s)
- Devon H Ghodasra
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Ryan Fante
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Thomas W Gardner
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Michael Langue
- Penn State Hershey Eye Center, Hershey, Pennsylvania, United States
| | - Leslie M Niziol
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Cagri Besirli
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Steven R Cohen
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Vaidehi S Dedania
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Hakan Demirci
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Nieraj Jain
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | | | - Mark W Johnson
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Partho S Kalyani
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - Rajesh C Rao
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
| | - David N Zacks
- Kellogg Eye Center University of Michigan, Ann Arbor, Michigan, United States
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Wang MZ, Feng K, Lu Y, Qian F, Lu XR, Zang SW, Zhao L. Predictors of short-term outcomes related to central subfield foveal thickness after intravitreal bevacizumab for macular edema due to central retinal vein occlusion. Int J Ophthalmol 2016; 9:86-92. [PMID: 26949616 DOI: 10.18240/ijo.2016.01.15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/25/2015] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate the predictive factors for short-term effects of intravitreal bevacizumab injections on central subfield foveal thickness (CSFT) in patients with macular edema (ME) secondary to central retinal vein occlusion (CRVO). METHODS This was a retrospective study in 60 eyes treated with intravitreal bevacizumab injections for ME due to CRVO. Follow-up was three months. The Early Treatment Diabetic Retinopathy Study (ETDRS) score and CSFT measured by spectral-domain optical coherence tomography (SD-OCT) were used to observe the changes in best-corrected visual acuity (BCVA). Baseline BCVA, CSFT, age, CRVO duration and the presence of cystoid macular edema (CME) or subretinal fluid (SRF) were analyzed as potential predictive factors of the effects of intravitreal bevacizumab injections. RESULTS BCVA improved from 0.9 logMAR at baseline to 0.6 logMAR at 3mo, which was associated with a significant reduction in CSFT from 721 µm to 392 µm 3mo after injection. About 50% of CME cases and more than 90% of SRF cases responded to treatment with a complete resolution at 3mo. Age (P=0.036) and low baseline CSFT (P=0.037) were associated with a good 3-month prognosis. Patients >60 years old achieved better CME resolution (P=0.031) and lower CSFT at 3mo (305 µm vs 474 µm, P=0.003). CONCLUSION Intravitreal bevacizumab significantly improved visual acuity and CSFT in patients with CRVO after 3mo. Older age and lower baseline CSFT were good predictors of short-term CSFT outcomes. The retinal thickness response to bevacizumab might depend on the resolution of CME rather than SRF.
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Affiliation(s)
- Mei-Zi Wang
- Department of Ophthalmology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
| | - Kang Feng
- Peking University Eye Center, Peking University Third Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, China
| | - Yao Lu
- Peking University Eye Center, Peking University Third Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, China
| | - Fang Qian
- Peking University Eye Center, Peking University Third Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, China
| | - Xin-Rong Lu
- Peking University Eye Center, Peking University Third Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, China
| | - Si-Wen Zang
- Peking University Eye Center, Peking University Third Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, China
| | - Lin Zhao
- Peking University Eye Center, Peking University Third Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing 100191, China
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Abstract
To evaluate whether intravitreal thrombin activity is elevated in eyes with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) in comparison to healthy controls. Prospective clinical case series of 19 patients with BRVO, 13 patients suffering from CRVO and nine participants serving as controls. Vitreous taps were extracted from the central vitreous body, 200 μl frozen/thawed sample was immediately stabilized with 200 μl 5% human albumin, and 200 μl mixture thereof was stabilized with 200 μl 2.5 mol/l arginine, pH 8.6. Thrombin activity was determined chromogenically. Intravitreal levels of vascular endothelial growth factor (VEGF) as a marker for blood-retina barrier (BRB) breakdown were measured by a commercial chemiluminescent enzyme immuno assay (R&D). Intravitreal thrombin activity and VEGF levels were 1.6 ± 1.2 mIU/ml (mean value ± SD; range: 0.2-4.2 mIU/ml) and 554 ± 568 pg/ml (range: 20-2005 pg/ml) in BRVO-affected eyes, 2.6 ± 1.2 mIU/ml (range: 0.8-5.2 mIU/ml) and 1332 ± 1350 pg/ml (range: 58-3943 pg/ml) in eyes suffering from CRVO as well as 0.8 ± 0.8 mIU/ml (range: 0.2-2.7 mIU/ml) and 115 ± 120 pg/ml (range: 32-431 pg/ml) in controls. There are significant differences of intravitreal thrombin activity and intravitreal VEGF levels between eyes with BRVO, CRVO, and controls (P = 0.007 and P = 0.003, Kruskal-Wallis test). Intravitreal thrombin activity is significantly correlated with intravitreal VEGF levels (r = 0656; P < 0.001, Pearson correlation). Intravitreal thrombin activity might serve as a new marker for BRB breakdown or macular fibrin deposition in ophthalmology. Significant differences of intravitreal thrombin activity between eyes with BRVO, CRVO, and healthy controls might offer new therapeutic strategies for RVO-affected eyes. The effect of oral and intravitrealy injected direct thrombin inhibitors needs to be evaluated in further investigations.
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Gerding H, Monés J, Tadayoni R, Boscia F, Pearce I, Priglinger S. Ranibizumab in retinal vein occlusion: treatment recommendations by an expert panel. Br J Ophthalmol 2015; 99:297-304. [PMID: 25075121 PMCID: PMC4345884 DOI: 10.1136/bjophthalmol-2014-305041] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 05/30/2014] [Accepted: 06/03/2014] [Indexed: 11/04/2022]
Abstract
Retinal vein occlusion (RVO) is a common cause of retinal vascular disease, resulting in potentially irreversible loss of vision despite the existence of several therapeutic options. The humanised monoclonal antibody fragment ranibizumab binds to and inhibits vascular endothelial growth factor, a key driver of macular oedema in RVO. In 2010, ranibizumab was approved in the USA for the treatment of macular oedema in RVO and, in 2011, ranibizumab was approved in the European Union for the treatment of visual impairment caused by macular oedema secondary to RVO in branch and central RVO. Ranibizumab provides an additional therapeutic option for this complex disease: an option that was not fully considered during the preparation of current international guidelines. An expert panel was convened to critically evaluate the evidence for treatment with ranibizumab in patients with visual impairment caused by macular oedema secondary to RVO and to develop treatment recommendations, with the aim of assisting physicians to optimise patient treatment.
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Affiliation(s)
- Heinrich Gerding
- Augenzentrum Klinik Pallas, Olten, Switzerland
- Department of Ophthalmology, University of Muenster, Muenster, Germany
| | - Jordi Monés
- Institut de la Màcula i de la Retina, Centro Médico Teknon and Barcelona Macula Foundation, Barcelona, Spain
| | - Ramin Tadayoni
- Department of Ophthalmology, Hôpital Lariboisière, Université Paris Diderot—Sorbonne Paris Cité, AP-HP, Paris, France
| | - Francesco Boscia
- Department of Ophthalmology, University of Sassari, Sassari, Italy
| | - Ian Pearce
- St Paul's Eye Unit, Royal Liverpool & Broadgreen University Hospitals NHS Trust, Liverpool, UK
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15
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Murthy KR, Goel R, Subbannayya Y, Jacob HK, Murthy PR, Manda SS, Patil AH, Sharma R, Sahasrabuddhe NA, Parashar A, Nair BG, Krishna V, Prasad TK, Gowda H, Pandey A. Proteomic analysis of human vitreous humor. Clin Proteomics 2014; 11:29. [PMID: 25097467 PMCID: PMC4106660 DOI: 10.1186/1559-0275-11-29] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 05/16/2014] [Indexed: 12/11/2022] Open
Abstract
Background The vitreous humor is a transparent, gelatinous mass whose main constituent is water. It plays an important role in providing metabolic nutrient requirements of the lens, coordinating eye growth and providing support to the retina. It is in close proximity to the retina and reflects many of the changes occurring in this tissue. The biochemical changes occurring in the vitreous could provide a better understanding about the pathophysiological processes that occur in vitreoretinopathy. In this study, we investigated the proteome of normal human vitreous humor using high resolution Fourier transform mass spectrometry. Results The vitreous humor was subjected to multiple fractionation techniques followed by LC-MS/MS analysis. We identified 1,205 proteins, 682 of which have not been described previously in the vitreous humor. Most proteins were localized to the extracellular space (24%), cytoplasm (20%) or plasma membrane (14%). Classification based on molecular function showed that 27% had catalytic activity, 10% structural activity, 10% binding activity, 4% cell and 4% transporter activity. Categorization for biological processes showed 28% participate in metabolism, 20% in cell communication and 13% in cell growth. The data have been deposited to the ProteomeXchange with identifier PXD000957. Conclusion This large catalog of vitreous proteins should facilitate biomedical research into pathological conditions of the eye including diabetic retinopathy, retinal detachment and cataract.
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Affiliation(s)
- Krishna R Murthy
- Institute of Bioinformatics, International Technology Park, Bangalore 560 066, India.,Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham, Kollam, Kerala 690 525, India.,Vittala International Institute Of Ophthalmology, Bangalore, Karnataka 560085, India
| | - Renu Goel
- Institute of Bioinformatics, International Technology Park, Bangalore 560 066, India.,Department of Biotechnology, Kuvempu University, Shankaraghatta, Karnataka 577 451, India
| | - Yashwanth Subbannayya
- Institute of Bioinformatics, International Technology Park, Bangalore 560 066, India
| | - Harrys Kc Jacob
- Institute of Bioinformatics, International Technology Park, Bangalore 560 066, India
| | - Praveen R Murthy
- Vittala International Institute Of Ophthalmology, Bangalore, Karnataka 560085, India
| | - Srikanth Srinivas Manda
- Institute of Bioinformatics, International Technology Park, Bangalore 560 066, India.,Centre of Excellence in Bioinformatics, Bioinformatics Centre, School of Life Sciences, Pondicherry University, Puducherry 605 014, India
| | - Arun H Patil
- Institute of Bioinformatics, International Technology Park, Bangalore 560 066, India
| | - Rakesh Sharma
- Department of Neurochemistry, National Institute of Mental Health and Neuro Sciences, Bangalore 560 006, India
| | | | | | - Bipin G Nair
- Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham, Kollam, Kerala 690 525, India
| | | | - Ts Keshava Prasad
- Institute of Bioinformatics, International Technology Park, Bangalore 560 066, India.,Amrita School of Biotechnology, Amrita Vishwa Vidyapeetham, Kollam, Kerala 690 525, India.,Centre of Excellence in Bioinformatics, Bioinformatics Centre, School of Life Sciences, Pondicherry University, Puducherry 605 014, India
| | - Harsha Gowda
- Institute of Bioinformatics, International Technology Park, Bangalore 560 066, India
| | - Akhilesh Pandey
- Department of Biological Chemistry, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore 21205 MD, USA.,Department of Oncology and Pathology, Johns Hopkins University School of Medicine, Baltimore 21205 MD, USA
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16
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Hao CH, Wang WT, Shao MX, Zhao ZY, Tang LD. Effects of Puerarin on Experimental Model of Retinal Vein Occlusion in Rats. CHINESE HERBAL MEDICINES 2014. [DOI: 10.1016/s1674-6384(14)60016-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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17
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Traustason S, la Cour M, Larsen M. Retinal vascular oximetry during ranibizumab treatment of central retinal vein occlusion. Br J Ophthalmol 2014; 98:1208-11. [DOI: 10.1136/bjophthalmol-2013-304580] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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PENTRAXIN 3 AND OTHER INFLAMMATORY FACTORS IN CENTRAL RETINAL VEIN OCCLUSION AND MACULAR EDEMA. Retina 2014; 34:352-9. [PMID: 23842103 DOI: 10.1097/iae.0b013e3182993d74] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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19
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Zhou S, Gao J, Xu X. Antivascular endothelial growth factors in the treatment of macular oedema secondary to central retinal vein occlusion: a meta-analysis. Clin Exp Ophthalmol 2014; 42:637-49. [PMID: 24330277 DOI: 10.1111/ceo.12286] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 11/29/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Macular oedema secondary to central retinal vein occlusion is a major cause of vision loss. Intraocuclar anti-vascular endothelial growth factor injection is a promising treatment but lacks clinical evidence of its safety and efficacy. DESIGN Meta-analysis. PARTICIPANTS Patients from previously reported randomized, controlled trials comparing intravitreal anti-vascular endothelial growth factor versus sham injections. METHODS A comprehensive search in MEDLINE, CENTRAL, and EMBASE was conducted for reports published by April 2013. A meta-analysis of the retrieved data was conducted in RevMan 5.2 software. MAIN OUTCOME MEASURES Primary outcome measures were changes in best-corrected visual acuity and central retinal thickness from baseline. Secondary outcome measures were the proportion of eyes changing 15 or more letters on the Early Treatment in Diabetic Retinopathy Study chart, the proportion with neovascularization and changes in the 25-item Visual Function Questionnaire. Severe adverse events were summarized to assess safety. RESULTS Six trials involving a total of 940 eyes were included in the meta-analysis. The mean difference in 6-month changes in best-corrected visual acuity and central retinal thickness for the anti-vascular endothelial growth factor group were 15.2 Early Treatment Diabetic Retinopathy Study letters (P < 0.00001) and -242.2 μm (P < 0.00001), respectively. Severe adverse event incidence was similar between the groups. CONCLUSIONS Intravitreal anti-vascular endothelial growth factor injections were safe and effective for macular oedema secondary to central retinal vein occlusion. The efficacy was rapid and robust. Further trials are needed to determine the detailed indications and therapeutic regimens of anti-vascular endothelial growth factor treatments.
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Affiliation(s)
- Shuangwen Zhou
- Department of Ophthalmology, Shanghai First People's Hospital, Shanghai Jiaotong University, Shanghai, China
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20
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Noma H, Mimura T, Kuse M, Shimada K. Association of electroretinogram and morphological findings in central retinal vein occlusion with macular edema. Clin Ophthalmol 2014; 8:191-7. [PMID: 24531560 PMCID: PMC3891666 DOI: 10.2147/opth.s54546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The objective of this study was to evaluate the relations among electroretinogram (ERG) parameters (cone a-wave, cone b-wave, and 30 Hz flicker), retinal thickness, and retinal volume in 16 patients with central retinal vein occlusion and macular edema. The amplitude and implicit time of the ERG parameters were extracted from the ERG traces. Retinal thickness and volume were measured by optical coherence tomography in nine macular subfields. Then the correlations among ERG parameters and morphological parameters were analyzed. The cone b-wave and 30 Hz flicker implicit time were correlated with retinal thickness and volume in seven out of nine subfields, excluding the temporal subfields. In addition, the amplitude of the cone b-wave was correlated with retinal thickness and volume in the nasal inner and nasal outer subfields. These findings suggest that retinal thickness and volume may be associated with outer and inner retinal function in central retinal vein occlusion patients.
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Affiliation(s)
- Hidetaka Noma
- Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, Chiba, Japan
| | - Tatsuya Mimura
- Department of Ophthalmology, Medical Center East, Tokyo Women's Medical University, Tokyo, Japan
| | - Manami Kuse
- Department of Ophthalmology, National Hospital Organization, Mie Central Medical Center, Tsu, Japan ; Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
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21
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Shen Q, Wu JZ, Wong JC. Potential drug interventions for diabetic retinopathy. Drug Discov Today 2013; 18:1334-41. [DOI: 10.1016/j.drudis.2013.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 08/14/2013] [Accepted: 08/23/2013] [Indexed: 01/03/2023]
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Pfister M, Rothweiler F, Michaelis M, Cinatl J, Schubert R, Koch FH, Koss MJ. Correlation of inflammatory and proangiogenic cytokines from undiluted vitreous samples with spectral domain OCT scans, in untreated branch retinal vein occlusion. Clin Ophthalmol 2013; 7:1061-7. [PMID: 23766628 PMCID: PMC3677846 DOI: 10.2147/opth.s42786] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose To assess the levels of inflammatory and angiogenic cytokines in undiluted vitreous from treatment-naïve patients with macular edema secondary to nonischemic branch retinal vein occlusion (BRVO), with flow cytometric bead array (CBA) and to correlate the results with subjective and multiple spectral-domain optical coherence tomography (SD-OCT) parameters. Methods A total of 43 eyes from 43 patients (mean age 69.7 years, 23 male) were divided into groups of new, “fresh” (n = 28; mean duration after onset 4.1 months) and older BRVO (n = 15; 11.6 months). Because of macular edema, these patients underwent an intravitreal therapy combining a single-site 23 g core vitrectomy with bevacizumab and dexamethasone. Undiluted vitreous was then analyzed for interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor isoform A (VEGF-A) levels with CBA and correlated with visual acuity (VA), clinical parameters of BRVO (type and perfusion status), and morphologic parameters, such as central macular thickness, central retinal thickness, thickness of the neurosensory retina, thickness of the serous retinal detachment, and the disruption of the ellipsoid line (photoreceptor inner and outer segments) and the external limiting membrane, as measured with SD-OCT. Twenty-eight undiluted vitreous samples from patients with idiopathic, nonuveitis vitreous floaters served as the controls. Results The mean IL-6 was 23.2 pg/mL (standard deviation, ±48.8), MCP-1 was 602.6 (±490.3), and VEGF-A was 161.8 (±314.3), and this was higher than in the control group, which had a mean IL-6 of 6.2 ± 3.4 pg/mL (P = 0.17), MCP-1 of 253.2 ± 73.5 (P < 0.0000001), and VEGF-A of 7.0 ± 4.9 (P < 0.003). In all BRVO samples, IL-6 correlated positively with MCP-1 and VEGF-A (correlation coefficient r = 0.79 and r = 0.46, respectively). VEGF-A was the only cytokine to correlate significantly with SD-OCT parameters (thickness of the neurosensory retina r = 0.31; disruption of the ellipsoid line r = 0.33). In the older BRVO group, there was a positive correlation between cytokines (IL-6 with MCP-1, r = 0.77; Il-6 with VEGF-A, r = 0.68; MCP-1 and VEGF-A, r = 0.68), whereas only IL-6 correlated with MCP-1 in the fresh group (r = 0.8). Conclusion The inflammatory markers and VEGF-A were elevated in the vitreous fluid of patients with BRVO, and these correlated with one another. VEGF-A was more often correlated with the morphologic changes assessed by SD-OCT, whereas the inflammatory markers had no significant influence on SD-OCT changes.
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Affiliation(s)
- Marcel Pfister
- Department of Ophthalmology, Goethe University, Frankfurt, Germany ; Doheny Eye Institute, University of Southern California, Los Angeles, CA, USA
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Noma H, Funatsu H, Mimura T. Changes of Inflammatory Factors After Intravitreal Triamcinolone Acetonide for Macular Edema with Central Retinal Vein Occlusion. J Ocul Pharmacol Ther 2013; 29:363-5. [DOI: 10.1089/jop.2011.0222] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Hidetaka Noma
- Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, Chiba, Japan
| | - Hideharu Funatsu
- Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, Chiba, Japan
| | - Tatsuya Mimura
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Koss M, Pfister M, Rothweiler F, Rejdak R, Ribeiro R, Cinatl J, Schubert R, Kohnen T, Koch F. Correlation from undiluted vitreous cytokines of untreated central retinal vein occlusion with spectral domain optical coherence tomography. Open Ophthalmol J 2013; 7:11-7. [PMID: 23560031 PMCID: PMC3613771 DOI: 10.2174/1874364101307010011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 01/15/2013] [Accepted: 01/15/2013] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To correlate inflammatory and proangiogenic key cytokines from undiluted vitreous of treatment-naïve central retinal vein occlusion (CRVO) patients with SD-OCT parameters. METHODS Thirty-five patients (age 71.1 years, 24 phakic, 30 nonischemic) underwent intravitreal combination therapy, including a single-site 23-gauge core vitrectomy. Twenty-eight samples from patients with idiopathic, non-uveitis floaterectomy served as controls. Interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF-A) levels were correlated with the visual acuity (logMar), category of CRVO (ischemic or nonischemic) and morphologic parameters, such as central macular thickness-CMT, thickness of neurosensory retina-TNeuro, extent of serous retinal detachment-SRT and disintegrity of the IS/OS and others. RESULTS The mean IL-6 was 64.7pg/ml (SD ± 115.8), MCP-1 1015.7 ( ± 970.1), and VEGF-A 278.4 ( ± 512.8), which was significantly higher than the control IL-6 6.2 ± 3.4pg/ml (P=0.06), MCP-1 253.2 ± 73.5 (P<0.0000001) and VEGF-A 7.0 ± 4.9 (P<0.0006). All cytokines correlated highly with one another (correlation coefficient r=0.82 for IL-6 and MCP-1; r=0.68 for Il-6 and VEGF-A; r=0.64 for MCP-1 and VEGF-A). IL-6 correlated significantly with CMT, TRT, SRT, dIS/OS, and dELM. MCP-1 correlated significantly with SRT, dIS/OS, and dELM. VEGF-A correlated not with changes in SD-OCT, while it had a trend to be higher in the ischemic versus the nonischemic CRVO group (P=0.09). CONCLUSIONS The inflammatory cytokines were more often correlated with morphologic changes assessed by SD-OCT, whereas VEGF-A did not correlate with CRVO-associated changes in SD-OCT. VEGF inhibition alone may not be sufficient in decreasing the inflammatory response in CRVO therapy.
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Affiliation(s)
- Mj Koss
- Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany ; Doheny Eye institute, Los Angeles, USA
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26
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Noma H, Mimura T, Shimada K. Retinal Function and Morphology in Central Retinal Vein Occlusion With Macular Edema. Curr Eye Res 2012; 38:143-9. [DOI: 10.3109/02713683.2012.724142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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27
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Maldonado RS, O'Connell R, Ascher SB, Sarin N, Freedman SF, Wallace DK, Chiu SJ, Farsiu S, Cotten M, Toth CA. Spectral-domain optical coherence tomographic assessment of severity of cystoid macular edema in retinopathy of prematurity. ACTA ACUST UNITED AC 2012; 130:569-78. [PMID: 22232366 DOI: 10.1001/archopthalmol.2011.1846] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To investigate whether the severity of cystoid macular edema (CME) in neonates who were 31 to 36 weeks' postmenstrual age, as viewed by spectral-domain optical coherence tomography (SD-OCT)imaging, predicts the severity of retinopathy of prematurity(ROP) or is related to systemic health. DESIGN Of 62 prematurely born neonates in a prospective institutional review board-approved study, 42 met the following inclusion criteria: at least 1 SD-OCT imaging session prior to 37 weeks' postmenstrual age and prior to ROP laser treatment, if a laser treatment was performed,and an ophthalmic ROP examination at or after 41 weeks' postmenstrual age, evidence of complete retinal vascularization in zone III, or documentation through telephone report of such information after transfer of care.Measures of CME severity, including central foveal thickness,retinal layer thicknesses, and foveal-to-parafoveal thickness ratio in 1 eye per subject, were compared with ROP outcomes: laser treatment, maximum plus disease,and maximum ROP stage. Systemic health factors were also correlated. RESULTS Cystoid macular edema was present in 50% of neonates. Multiple elongated cystoid structures within the inner nuclear layer were most common. The presence of CME was not associated with ROP outcomes. The central foveal thickness, the thickness of the inner retinal layers, and the foveal-to-parafoveal thickness ratio were higher in eyes that required laser treatment or that developed plus disease or ROP stage 3. Cystoid macular edema was not clearly associated with systemic factors. CONCLUSIONS Cystoid macular edema is common in premature infants screened for ROP before 37 weeks' postmenstrual age, with the most common SD-OCT phenotype ofa bulging fovea from multiple elongated cystoid spaces. Detection of CME is not associated with ROP severity; however,tomographic thickness measurements could potentially predict a higher risk of requiring laser treatment or developing plus disease or ROP stage 3. Systemic health factors are probably not related to the development of CME.
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Affiliation(s)
- Ramiro S Maldonado
- Department of Ophthalmology, Duke Eye Center, Duke University, Durham, NC 27705, USA
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Koss MJ, Pfister M, Rothweiler F, Michaelis M, Cinatl J, Schubert R, Koch FH. Comparison of cytokine levels from undiluted vitreous of untreated patients with retinal vein occlusion. Acta Ophthalmol 2012; 90:e98-e103. [PMID: 22066978 DOI: 10.1111/j.1755-3768.2011.02292.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare cytokines in undiluted vitreous of treatment-naïve patients with macular oedema without vitreomacular traction secondary to branch (BRVO), central (CRVO) and hemi-central (H-CRVO) retinal vein occlusion. METHODS Ninety-four patients (median age 72 years, 42 men) underwent an intravitreal combination therapy, including a single-site 23-gauge core vitrectomy and the application of bevacizumab and dexamethasone due to vision-decreasing macular oedema. Among these were 43 patients with BRVO, 35 with CRVO and 16 patients with hemi-CRVO, which were distributed in a fresh or old retinal vein occlusion type (seven or more months after onset). Undiluted vitreous samples were analysed for interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and vascular endothelial growth factor (VEGF-A) with cytometric BEAD assay. Vitreous samples from patients with idiopathic epiretinal membrane served as controls (n = 14). RESULTS The mean cytokine values were highest in the CRVO group with IL-6 = 64.7 pg/ml (SD ± 115.8), MCP-1 = 1015.8 pg/ml (±970.1) and VEGF-A = 278.4 pg/ml (±512.8), followed by the H-CRVO group with IL-6 = 59.9 pg/ml (SD ± 97.5), MCP-1 = 938.8 pg/ml (±561.1) and VEGF-A = 211.5 pg/ml (±232.4). The BRVO group had IL-6 = 23.2 pg/ml (SD ± 48.8), MCP-1 = 602.6 g/ml (±490.3) and VEGF-A = 161.8 pg/ml (±314.4). The values of MCP-1 and VEGF-A were significantly different for CRVO or H-CRVO versus BRVO. All values were significantly higher than in the control samples, which had 6.2 ± 3.4 pg/ml (IL-6), 253 ± 74 pg/ml (MCP-1) and 7 ± 4.9 pg/ml (VEGF-A). Within the old RVO type, only MCP-1 was significantly different for CRVO or H-CRVO versus BRVO. CONCLUSIONS Both inflammatory markers and VEGF-A were higher in CRVO and H-CRVO than in BRVO undiluted vitreous samples. It seems that monocyte recruitment to the vessel wall, which might underlie the importance of eosinophils in tissue remodelling after RVO, is of special interest owing to the significant difference in MCP-1 in the older RVO types.
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Affiliation(s)
- Michael J Koss
- Department of Ophthalmology, Section of Vitreo-Retinal Surgery, Goethe University, 60590 Frankfurt am Main, Germany.
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Lange CA, Bainbridge JW. Oxygen Sensing in Retinal Health and Disease. Ophthalmologica 2012; 227:115-31. [DOI: 10.1159/000331418] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 07/29/2011] [Indexed: 12/24/2022]
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Vitreous inflammatory factors and serous retinal detachment in central retinal vein occlusion: a case control series. JOURNAL OF INFLAMMATION-LONDON 2011; 8:38. [PMID: 22152024 PMCID: PMC3253063 DOI: 10.1186/1476-9255-8-38] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 12/12/2011] [Indexed: 11/15/2022]
Abstract
Background This study investigated whether the vitreous fluid levels of soluble vascular endothelial growth factor receptor-2 (sVEGFR-2), pigment epithelium-derived factor (PEDF), and soluble intercellular adhesion molecule 1 (sICAM-1) were associated with the occurrence of serous retinal detachment (SRD) in patients with central retinal vein occlusion (CRVO). Methods We recruited 33 patients with CRVO and macular edema, as well as 18 controls with nonischemic ocular diseases. Eighteen of the 33 patients with CRVO showed SRD on optical coherence tomography of the macula (defined as subretinal accumulation of fluid with low reflectivity), while the other 15 patients only had cystoid macular edema (CME, defined as hyporeflective intraretinal cavities). Retinal ischemia was evaluated by measuring the area of capillary non-perfusion using fluorescein angiography and the public domain Scion Image program, while central macular thickness (CMT) was examined by optical coherence tomography. Vitreous fluid samples were obtained during pars plana vitrectomy and levels of the target molecules were measured by enzyme-linked immunosorbent assay. Results Ischemia was significantly more common in the SRD group (17/18 patients) than in the CME group (5/15 patients) (P < 0.001). The vitreous fluid level of sICAM-1 increased significantly across the three groups from the control group (4.98 ± 1.73 ng/ml) to the CME group (15.4 ± 10.1 ng/ml) and the SRD group (27.1 ± 17.7 ng/ml) (ptrend< 0.001). The vitreous fluid level of sVEGFR-2 also showed a significant increase across the three groups (1083 ± 541 pg/ml, 1181 ± 522 pg/ml, and 1535 ± 617 pg/ml, respectively, ptrend = 0.019). On the other hand, the vitreous fluid level of PEDF showed a significant decrease across the three groups (56.4 ± 40.0 ng/ml, 24.3 ± 17.3 ng/ml, and 16.4 ± 12.6 ng/ml, respectively, ptrend< 0.001). Conclusions Higher levels of inflammatory factors (sICAM-1 and sVEGFR-2) and lower levels of anti-inflammatory PEDF were observed in macular edema patients with SRD, suggesting that inflammation plays a key role in determining the severity of CRVO.
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Noma H, Funatsu H, Mimura T, Eguchi S, Shimada K. Influence of vitreous factors after vitrectomy for macular edema in patients with central retinal vein occlusion. Int Ophthalmol 2011; 31:393-402. [DOI: 10.1007/s10792-011-9480-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2011] [Accepted: 09/14/2011] [Indexed: 11/29/2022]
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