Aqueous humor monocyte chemoattractant protein-1 predicted long-term visual outcome of proliferative diabetic retinopathy undergone intravitreal injection of bevacizumab and vitrectomy

Abstract

Purpose We aim to investigate the risk factors associated with the prognosis of proliferative diabetic retinopathy (PDR) after a sequential treatment of intravitreal injection of bevacizumab (IVB) and pars plana vitrectomy (PPV). Methods In this cohort study, 63 eyes from 55 patients (21 females) diagnosed with PDR, who needed PPV for non-clearing vitreous hemorrhage or fibrovascular membrane proliferation were enrolled. All the eyes underwent IVB followed by PPV. Anterior chamber tap was performed at the beginning of both procedures to evaluate the concentration of vascular endothelial growth factor (VEGF), interleukin (IL)-6, IL-8, and monocyte chemoattractant protein (MCP)-1. Results Forty-seven patients (54 eyes) were followed over six months, averaging 12±5 (6–19) months. The concentration of VEGF significantly decreased after IVB (P<0.001), while other cytokines did not change significantly. The aqueous humor level of IL-8 after IVB (R = 0.378, P = 0.033), MCP-1 before (R = 0.368, P = 0.021) and after (R = 0.368, P = 0.038) IVB, and combined phacoemulsification (R = 0.293, P = 0.032) was correlated with the logMAR visual acuity at the last follow-up. Multivariate analysis showed that MCP-1 was the predictor for a worse visual outcome (B = 0.108, 95% CI 0.013–0.202; P = 0.027). Conclusions MCP-1 was a predictor for the unfavorable visual outcome of PDR after IVB pretreatment and PPV.

Local Inflammatory Biomarkers and Potential Inflammation-Targeting Therapies in Diabetic Retinopathy

“…MCP-1 level in AH is believed to be a predictor for a worse visual acuity outcome of PDR patients after vitrectomy, while there was no significant correlation between VEGF levels and BCVA, as noted by Lei et al [39]. MCP-1 stimulates the recruitment and activation of monocytes and macrophages which further leads to higher microvascular permeability or ischemia from vessel occlusions.…”