Analysis of Cytokines in the Aqueous Humor During Intravitreal Treatment With Ranibizumab in Diabetic Macular Edema

Abstract

\n Purpose: This study aimed to analyze the concentrations, in aqueous humor, of VEGF, b-FGF, TNF, and interleukins 1, 6, 8, 10, and 12 in patients with diabetic macular edema, with and without peripheral retinal ischemia, and to analyze the variation of the levels of these molecules, during the treatment with ranibizumab.Methods: A therapeutic, prospective, randomized interventional study was carried out. Twenty-four eyes from 24 patients were studied, divided into 3 groups. Group 1, (9 eyes), patients with EMD without peripheral ischemia. Group 2 (10 eyes), patients with EMD with peripheral ischemia. Group 3, (5 eyes), control group, formed by patients without systemic and/or eye diseases. Patients in groups 1 and 2 were treated with 3 intravitreal injections of 2 mg/0.05 ml of ranibizumab, with intervals of approximately 30 days. Before performing the injections, the aqueous humor was collected. In the control group, the material was collected before the facectomy procedure. Results: During treatment, the medians of IL-6 concentrations showed a statistically significant increase, in group 1 and group 2, there was a slight decrease, not statistically significant. Interleukin 8 showed statistically significant variations in groups 1 and 2, at the end of treatment. TNF, IL-1, IL-10, and IL-12 had their concentrations practically unchanged, in both groups. VEGF showed a statistically significant reduction in groups 1 and 2 at the end of the study. B-FGF was not detected in most of the studied patients, and in those that were found, they did not present statistically significant numbers. Conclusion: There were statistically significant variations in the increase of their median levels in interleukin 6, in the group without ischemia and a decrease in VEGF in both groups. The cytokines TNF, IL-1, IL-10, and IL-12 did not show statistically significant variations.