Aqueous cytokines as predictors of macular edema in patients with diabetes following uncomplicated phacoemulsification cataract surgery

Ning Dong, Bing Xu, Bingsong Wang, Liqun Chu, Xin Tang, Ning Dong, Bing Xu, Bingsong Wang, Liqun Chu, Xin Tang

Abstract

This study aims to ascertain whether cytokines in the aqueous humor can predict macular edema (ME) in diabetic patients following uncomplicated phacoemulsification cataract surgery. Undiluted aqueous humor samples were obtained from 136 consecutive type 2 diabetic patients who underwent cataract surgery. The concentrations of 27 cytokines were measured in aqueous humor using the multiplex bead immunoassay. At the final follow-up examination, 116 patients completed 4 weeks of follow-up, and the incidence of macular edema was 29.31% (34 patients) 4 weeks after cataract surgery. Compared to the ME (-) patients, the concentrations of interleukin-1β (IL-1β) (P < 0.001), IL-6 (P < 0.001), IL-8 (P < 0.001), interferon-induced protein-10 (IP-10) (P = 0.003), monocyte chemotactic protein-1 (MCP-1) (P < 0.001), and vascular endothelial growth factor (VEGF) (P < 0.001) in the ME (+) patients were significantly higher. In addition, the aqueous levels of IL-1β (r = 0.288), IL-6 (r = 0.345), IL-8 (r = 0.256), IP-10 (r = 0.377), MCP-1 (r = 0.423), and VEGF (r = 0.279) were positively correlated with the postoperative foveal center point thickness (FCPT). However, the aqueous levels of IL-10 (P = 0.003) and IL-12 (P = 0.017) were significantly lower in patients with ME. These results suggest IL-1β, IL-6, IL-8, IL-10, IL-12, IP-10, MCP-1, and VEGF may be potential predictors of postoperative macular thickness in patients with diabetes following uncomplicated phacoemulsification cataract surgery.

References

    1. Jia W. P., Pang C., Chen L., et al. Epidemiological characteristics of diabetes mellitus and impaired glucose regulation in a Chinese adult population: the Shanghai Diabetes Studies, a cross-sectional 3-year follow-up study in Shanghai urban communities. Diabetologia. 2007;50(2):286–292. doi: 10.1007/s00125-006-0503-1.
    1. Klein B. E. K., Klein R., Moss S. E. Prevalence of cataracts in a population-based study of persons with diabetes mellitus. Ophthalmology. 1985;92(9):1191–1196. doi: 10.1016/S0161-6420(85)33877-0.
    1. Vukicevic M., Gin T., Al-Qureshi S. Prevalence of optical coherence tomography-diagnosed postoperative cystoid macular oedema in patients following uncomplicated phaco-emulsification cataract surgery. Clinical and Experimental Ophthalmology. 2012;40(3):282–287. doi: 10.1111/j.1442-9071.2011.02638.x.
    1. Menchini U., Cappelli S., Virgili G. Cataract surgery and diabetic retinopathy. Seminars in Ophthalmology. 2003;18(3):103–108. doi: 10.1076/soph.18.3.103.29805.
    1. Dieleman M., Wubbels R. J., Van Kooten-Noordzij M., de Waard P. W. T. Single perioperative subconjunctival steroid depot versus postoperative steroid eyedrops to prevent intraocular inflammation and macular edema after cataract surgery. Journal of Cataract and Refractive Surgery. 2011;37(9):1589–1597. doi: 10.1016/j.jcrs.2011.03.049.
    1. Pollack A., Leiba H., Bukelman A., Oliver M. Cystoid macular oedema following cataract extraction in patients with diabetes. British Journal of Ophthalmology. 1992;76(4):221–224. doi: 10.1136/bjo.76.4.221.
    1. Benson W. E., Brown G. C., Tasman W., McNamara J. A., Vander J. F. Extracapsular cataract extraction with placement of a posterior chamber lens in patients with diabetic retinopathy. Ophthalmology. 1993;100(5):730–738. doi: 10.1016/S0161-6420(93)31582-4.
    1. Mittra R. A., Borrillo J. L., Dev S., Mieler W. F., Koenig S. B. Retinopathy progression and visual outcomes after phacoemulsification in patients with diabetes mellitus. Archives of Ophthalmology. 2000;118(7):912–917.
    1. Chung J., Kim M. Y., Kim H. S., Yoo J. S., Lee Y. C. Effect of cataract surgery on the progression of diabetic retinopathy. Journal of Cataract and Refractive Surgery. 2002;28(4):626–630. doi: 10.1016/S0886-3350(01)01142-7.
    1. Bélair M.-L., Kim S. J., Thorne J. E., et al. Incidence of cystoid macular edema after cataract surgery in patients with and without uveitis using optical coherence tomography. American Journal of Ophthalmology. 2009;148(1):128–135. doi: 10.1016/j.ajo.2009.02.029.
    1. Gulkilik G., Kocabora S., Taskapili M., Engin G. Cystoid macular edema after phacoemulsification: risk factors and effect on visual acuity. Canadian Journal of Ophthalmology. 2006;41(6):699–703. doi: 10.1139/I06-062.
    1. Benitah N. R., Arroyo J. G. Pseudophakic cystoid macular edema. International Ophthalmology Clinics. 2010;50(1):139–153. doi: 10.1097/IIO.0b013e3181c551da.
    1. Funatsu H., Yamashita H., Noma H., Shimizu E., Mimura T., Hori S. Prediction of macular edema exacerbation after phacoemulsification in patients with nonproliferative diabetic retinopathy. Journal of Cataract and Refractive Surgery. 2002;28(8):1355–1363. doi: 10.1016/S0886-3350(02)01243-9.
    1. Liu J., Shi B., He S., Yao X., Willcox M. D. P., Zhao Z. Changes to tear cytokines of type 2 diabetic patients with or without retinopathy. Molecular Vision. 2010;16:2931–2938.
    1. Chu L., Wang B., Xu B., Dong N. Aqueous cytokines as predictors of macular edema in non-diabetic patients following uncomplicated phacoemulsification cataract surgery. Molecular Vision. 2013;19:2418–2425.
    1. Dong N., Xu B., Wang B., Chu L. Study of 27 aqueous humor cytokines in patients with type 2 diabetes with or without retinopathy. Molecular Vision. 2013;19:1734–1746.
    1. Kim S. J., Equi R., Bressler N. M. Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography. Ophthalmology. 2007;114(5):881–889. doi: 10.1016/j.ophtha.2006.08.053.
    1. Perente I., Utine C. A., Ozturker C., et al. Evaluation of macular changes after uncomplicated phacoemulsification surgery by optical coherence tomography. Current Eye Research. 2007;32(3):241–247. doi: 10.1080/02713680601160610.
    1. Buyukyildiz H. Z., Gulkilik G., Kumcuoglu Y. Z. Early serous macular detachment after phacoemulsification surgery. Journal of Cataract and Refractive Surgery. 2010;36(11):1999–2002. doi: 10.1016/j.jcrs.2010.07.007.
    1. Hernández C., Segura R. M., Fonollosa A., Carrasco E., Francisco G., Simó R. Interleukin-8, monocyte chemoattractant protein-1 and IL-10 in the vitreous fluid of patients with proliferative diabetic retinopathy. Diabetic Medicine. 2005;22(6):719–722. doi: 10.1111/j.1464-5491.2005.01538.x.
    1. Abu El-Asrar A. M., Struyf S., Kangave D., Geboes K., van Damme J. Chemokines in proliferative diabetic retinopathy and proliferative vitreoretinopathy. European Cytokine Network. 2006;17(3):155–165.
    1. Funatsu H., Yamashita H., Ikeda T., Mimura T., Eguchi S., Hori S. Vitreous levels of interleukin-6 and vascular endothelial growth factor are related to diabetic macular edema. Ophthalmology. 2003;110(9):1690–1696. doi: 10.1016/S0161-6420(03)00568-2.
    1. Ozturk B. T., Bozkurt B., Kerimoglu H., Okka M., Kamis U., Gunduz K. Effect of serum cytokines and VEGF levels on diabetic retinopathy and macular thickness. Molecular Vision. 2009;15:1906–1914.
    1. Mitamura Y., Takeuchi S., Matsuda A., Tagawa Y., Mizue Y., Nishihira J. Monocyte chemotactic protein-1 in the vitreous of patients with proliferative diabetic retinopathy. Ophthalmologica. 2001;215(6):415–418. doi: 10.1159/000050900.
    1. Dong N., Li X., Xiao L., Yu W., Wang B., Chu L. Upregulation of retinal neuronal MCP-1 in the rodent model of diabetic retinopathy and its function in vitro. Investigative Ophthalmology and Visual Science. 2012;53(12):7567–7575. doi: 10.1167/iovs.12-9446.
    1. Yonekawa Y., Kim I. K. Pseudophakic cystoid macular edema. Current Opinion in Ophthalmology. 2012;23(1):26–32. doi: 10.1097/ICU.0b013e32834cd5f8.
    1. Funk M., Schmidinger G., Maar N., et al. Angiogenic and inflammatory markers in the intraocular fluid of eyes with diabetic macular edema and influence of therapy with bevacizumab. Retina. 2010;30(9):1412–1419. doi: 10.1097/IAE.0b013e3181e095c0.
    1. Sohn H. J., Han D. H., Kim I. T., et al. Changes in aqueous concentrations of various cytokines after intravitreal triamcinolone versus bevacizumab for diabetic macular edema. American Journal of Ophthalmology. 2011;152(4):686–694. doi: 10.1016/j.ajo.2011.03.033.
    1. Limb G. A., Little B. C., Meager A., et al. Cytokines in proliferative vitreoretinopathy. Eye. 1991;5, part 6:686–693.
    1. Murugeswari P., Shukla D., Rajendran A., Kim R., Namperumalsamy P., Muthukkaruppan V. Proinflammatory cytokines and angiogenic and anti-angiogenic factors in vitreous of patients with proliferative diabetic retinopathy and eales' disease. Retina. 2008;28(6):817–824. doi: 10.1097/IAE.0b013e31816576d5.
    1. Rothwell N. J., Luheshi G. N. Interleukin 1 in the brain: biology, pathology and therapeutic target. Trends in Neurosciences. 2000;23(12):618–625. doi: 10.1016/S0166-2236(00)01661-1.
    1. Kowluru R. A., Odenbach S. Role of interleukin-1β in the pathogenesis of diabetic retinopathy. British Journal of Ophthalmology. 2004;88(10):1343–1347. doi: 10.1136/bjo.2003.038133.
    1. Vincent J. A., Mohr S. Inhibition of caspase-1/interleukin-1β signaling prevents degeneration of retinal capillaries in diabetes and galactosemia. Diabetes. 2007;56(1):224–230. doi: 10.2337/db06-0427.
    1. Moriarty A. P., Spalton D. J., Moriarty B. J., Shilling J. S., Ffytche T. J., Bulsara M. Studies of the blood-aqueous barrier in diabetes mellitus. American Journal of Ophthalmology. 1994;117(6):768–771. doi: 10.1016/S0002-9394(14)70320-4.
    1. Petrovič M. G., Korošec P., Košnik M., Hawlina M. Vitreous levels of interleukin-8 in patients with proliferative diabetic retinopathy. American Journal of Ophthalmology. 2007;143(1):175–176. doi: 10.1016/j.ajo.2006.07.032.
    1. Loetscher M., Gerber B., Loetscher P., et al. Chemokine receptor specific for IP10 and Mig: structure, function, and expression in activate T-lymphocytes. The Journal of Experimental Medicine. 1996;184(3):963–969. doi: 10.1084/jem.184.3.963.
    1. Penny L. A. Monocyte chemoattractant protein 1 in luteolysis. Reviews of Reproduction. 2000;5(2):63–66. doi: 10.1530/ror.0.0050063.
    1. Aiello L. P., Avery R. L., Arrigg P. G., et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. The New England Journal of Medicine. 1994;331(22):1480–1487. doi: 10.1056/NEJM199412013312203.
    1. Funatsu H., Yamashita H., Shimizu E., Kojima R., Hori S. Relationship between vascular endothelial growth factor and interleukin-6 in diabetic retinopathy. Retina. 2001;21(5):469–477. doi: 10.1097/00006982-200110000-00009.
    1. Rubio-Perez J. M., Morillas-Ruiz J. M. A review: inflammatory process in Alzheimer's disease, role of cytokines. The Scientific World Journal. 2012;2012:15. doi: 10.1100/2012/756357.756357
    1. Silvestre J.-S., Mallat Z., Duriez M., et al. Antiangiogenic effect of interleukin-10 in ischemia-induced angiogenesis in mice hindlimb. Circulation Research. 2000;87(6):448–452. doi: 10.1161/01.RES.87.6.448.
    1. Sgadari C., Angiolillo A. L., Tosato G. Inhibition of angiogenesis by interleukin-12 is mediated by the interferon-inducible protein 10. Blood. 1996;87(9):3877–3882.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅