Article Text

Download PDFPDF
Aqueous cytokine and growth factor levels indicate response to ranibizumab for diabetic macular oedema
  1. Masahiko Shimura,
  2. Kanako Yasuda,
  3. Ryosuke Motohashi,
  4. Osamu Kotake,
  5. Hidetaka Noma
  1. Department of Ophthalmology, Tokyo Medical University Hachioji Medical Center, Hachioji, Tokyo, Japan
  1. Correspondence to Dr Masahiko Shimura, Department of Ophthalmology, Tokyo Medical University Hachioji Medical Center, 1163 Tate-machi, Hachioji, Tokyo 193-0998, Japan; masahiko{at}


Background/Aims To investigate the relations between aqueous humour levels of cytokines/growth factors and treatment response to intravitreal ranibizumab (IVR) for diabetic macular oedema (DME)

Methods Sixty-eight eyes of 68 patients with treatment-naïve centre-involved DME, central macular thickness (CMT) greater than 400 μm and visual acuity (VA) worse than logMAR 0.3 were recruited. Each patient received monthly IVR injection (0.5 mg/0.05 mL) until CMT was reduced to below 300 μm. Additional IVR was given to maintain CMT below 300 μm during the clinical course of 6 months with monthly follow-up. Aqueous concentrations of cytokines/chemokines and growth factors were measured using samples obtained just before first IVR injection. CMT and VA were monitored monthly for up to 6 months. The number of monthly IVR injections given during the 6-month study period was also recorded.

Results Twenty-four eyes showed CMT <300 μm soon after the first IVR injection (good responders), while 12 eyes did not reach the goal after six consecutive injections (poor responders). Baseline CMT and VA were not significantly different between the two groups. However, the good responders showed significant increases in baseline aqueous concentrations of vascular endothelial growth factor (VEGF), placenta growth factor, soluble VEGF receptor-1 (sVEGFR1), monocyte chemoattractant protein-1, intercellular adhesion molecule-1, interleukin 6 and inducible protein-10, but not of sVEGFR2, compared with poor responders.

Conclusions Response to ranibizumab treatment for DME appears to be associated with aqueous concentrations of VEGFR1 family and certain inflammatory cytokines, but not with clinical parameters.

  • Aqueous humour
  • Macula
  • Retina
  • Treatment Medical

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors MS: the conception and design of the work. KY, RM and OK: the acquisition of data. HN and MS: the analysis of data. All authors: the interpretation of data and discussion, final approval of the version to be published. MS: writing manuscript.

  • Funding This work is supported by JSPS KAKENHI Grant Number JP25462737 and 2013 Scientific Grant in aid for Clinical Research about age-related ocular disease.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Tokyo Medical University Hachioji Medical Center Clinical Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost B Jonas