Original articleIncreased levels of vascular endothelial growth factor and interleukin-6 in the aqueous humor of diabetics with macular edema☆
Section snippets
Subjects
: We obtained undiluted aqueous humor samples and corresponding plasma samples from 54 diabetic patients (54 eyes) undergoing cataract surgery (Table 1). There were 27 men and 27 women with a mean age of 62.5 years (range, 38 to 70 years). The mean duration of diabetes was 16.9 years (range, 1 to 28 years) and the mean one-year average HbA1c value was 7.3% (range: 5.4% to 12.9%). The protocol for sample collection was approved by the institutional review board and all patients gave informed
Severity of retinopathy and macular edema
The severity of retinopathy was as follows: 14 eyes were level 10, 10 eyes were level 20, 18 eyes were level 35, 4 eyes were level 43, 4 eyes were level 47, and 4 eyes were level 53. There were 28 eyes with no macular edema, 18 eyes with focal macular edema, and 8 eyes with diffuse macular edema or CME. The average preoperative visual acuity was 20/40 (range: finger motion to 40/50). The visual acuity was 20/40 or better in 28 eyes, 20/50 to 20/100 in 22, and 20/100 or worse in 4.
Severity of macular edema and cytokine levels
: The VEGF
Discussion
The major findings of this study were as follows : (1) the aqueous levels of VEGF and IL-6 are closely correlated with the severity of macular edema, (2) VEGF and IL-6 levels in the aqueous humor are higher than the corresponding plasma levels, (3) aqueous levels of VEGF and IL-6 are strongly correlated with the aqueous protein concentration, (4) the status of the posterior vitreous is correlated with the severity of macular edema, and (5) the aqueous levels of VEGF, IL-6, and protein are
Acknowledgements
We thank Dr. Shigehiko Kitano, Dr. Yuichiro Nakanishi, Dr. Kensuke Haruyama, and Dr. Shinko Nakamura for their assistance in collecting the aqueous and plasma samples and performing the ophthalmologic examinations. We also thank Dr. Yasuhiko Iwamoto and Dr. Naoko Iwasaki for their assistance in performing the general medical examinations. Finally, we would like to thank Katsunori Shimada for conducting the statistical analysis.
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This study was supported by a Health Science Research Grant (#10060101, to Drs. Funatsu, Hori, and Yamashita) from the Japanese Ministry of Health and Welfare for Research on Eye and Ear Sciences, Immunology, Allergy and Organ Transplantation.