A Novel Biomarker in Diabetic Macular Edema with Serous Retinal Detachment: Serum Chitinase-3-Like Protein 1

Abstract

Purpose: To determine whether serum chitinase-3-like protein 1 (CHI3L1) and interleukin-6 (IL-6) levels correlate with serous retinal detachment (SRD) in diabetic macular edema (DME) using spectral-domain optical coherence tomography (SD-OCT). Methods: In this cross-sectional case-control study, 394 patients (treatment-naive DME patients, n = 218; diabetic patients without DME, n = 96; nondiabetic controls, n = 80) were included in the study. Eyes were classified according to SD-OCT features of DME: SRD, cystoid macular edema (CMO), and diffuse retinal thickness (DRT). Serum concentrations of CHI3L1 and IL-6 were analyzed using enzyme-linked immunosorbent assay. Results: Serum CHI3L1 and IL-6 levels were significantly higher in DME with SRD compared to patients with CMO and DRT (p < 0.001 for all groups). Multivariate regression analysis showed that CHI3L1 and IL-6 had a stronger influence on the presence of SRD in DME (r = 1.162, p = 0.026, and r = 1.242, p = 0.016, respectively). Serum concentration of CHI3L1 was significantly correlated with that of IL-6 (r = 0.386, p = 0.0015). Conclusions: Our data suggest that serum concentrations of CHI3L1 and IL-6 are involved in the process of SRD in DME. CHI3L1 can be investigated further as a new diagnostic biomarker for DME with SRD.

Evaluation of Chitotriosidase and Neopterin as Biomarkers of Microvascular Complications in Patients with Type 1 Diabetes Mellitus

“…In this study, patients with retinopathy (regardless of its progression) had significantly higher values of serum chitotriosidase, than those in whom retinopathy was still undetected. Our results support those observed in patients with type 2 DM and retinopathy, where the protein YKL-40, a member of the same family as chitotriosidase, had been proposed as a predictive marker of macular oedema and retinal detachment [7,25,28,29]. As in the case of neuropathy, serum levels of neopterin were increased in patients with retinopathy, but this variation lacked statistical significance.…”

Effects of dexamethasone treatment on serous retinal detachment in ranibizumab-resistant diabetic macular edema

“…For example, SRD is defined as fluid accumulation in the subretinal space as a result of retinal pigment epithelium dysfunction and damage to the external limiting membrane. 9,10 DRT results from ischemiainduced intracytoplasmic swelling of Müller cells, and if Müller cells have necrosis with cavity formation, CME results. 7,8 Several studies in the current literature aim to explain the effects of treatment modalities on SRD and non-SRD patients.…”

“…DRT and CME are mainly caused by dysfunction of the inner blood-retinal barriers. [7][8][9][10] Due to differences in pathogenic mechanisms, DME can be divided in two groups: (1) SRD and (2) non-SRD (DRT CME).…”

Effect of Optical Coherence Tomography Patterns on One-year Outcomes of Aflibercept Therapy for Diabetic Macular Edema

“…Higher levels of IL-6 in SRD type compared to DRT and CME also suggest that inflammation has an important role in pathogenesis. 20 The relationship between SRD and visual functions in diabetic macular edema is controversial. A post-hoc analysis of RISE and RIDE trials showed that the presence of baseline subretinal fluid was predictive for better visual outcomes than those without baseline SRD.…”