Inflammatory cytokines, oxidative and antioxidative stress levels in patients with diabetic macular edema and hyperreflective spots

Abstract

Purpose: To determine the levels of serum oxidative, antioxidative markers and inflammatory cytokines in patients diagnosed with diabetic macular edema (DME) whose hyperreflective spots (HRS) were detected by optical coherence tomography (OCT). Methods: In this prospective cross-sectional clinical study included a total of 88 patients; 31 patients (group-1) with DME and HRS detected by OCT, 29 patients (group-2) with DME without HRS, and 28 patients (group-3) diagnosed with diabetes mellitus (DM) without any diabetic retinopathy findings. The main outcomes were best-corrected visual acuity (BCVA), CMT (central macular thickness), CMV (central macular volume), TMV (total macular volume), CT (choroidal thickness), serum TAS (total antioxidant status), TOS (total oxidant status), VEGF (vascular endothelial growth factor), FGF (fibroblast growth factor) and IL-1b levels. OCT parameters and biochemical measurements were compared statistically between the three groups. Results: A total of 88 patients (43 females (48.9%) and 45 males (51.1%)) were included in the study. The mean age was 56.29 ± 9.23 years. There was no difference between the three groups in age-and-sex. In group-1 and 2, BCVA(LogMAR) was statistically higher than group 3. CMT, CMV, TMV, TAS, TOS, VEGF and FGF were significantly higher in group-1 than in group-3. CMT, CMV, TMV, VEGF and FGF were significantly higher in group-2 than group 3. TOS and VEGF were significantly higher in group-1 than group-2. Conclusions: This study demonstrates that in patients with DME and HRS, TOS and VEGF levels were higher than those without HRS. Hence, hyperreflective spots may be an inflammatory biomarker.

The relationship between peripheral blood inflammatory markers and diabetic macular edema in patients with severe diabetic retinopathy

“…Due to inflammation and oxidative stress, DRT leads to the impairment of the outer retinal barrier, causing increased vascular permeability (30). The hyperreflective spots observed on OCT may be the activated microglia, which are associated with a severe inflammatory response (7,27). These findings all suggest a close association between DME and inflammation.…”

“…However, clinical trials have shown that approximately 40% of patients are non-responsive to anti-VEGFs (6). While more recent research suggests that inflammatory factors play key roles in the development of DME (7,8). Increased levels of inflammatory mediators may lead to early and sustained chronic inflammation of diabetic retina, leukocyte activation, adhesion to vascular endothelium, disruption of blood retinal barrier, increased vascular permeability, and eventually macular edema.…”

Prevalence and Factors Associated with Diabetic Retinopathy among Adult Diabetes Patients in Southeast Ethiopia: A Hospital-Based Cross-Sectional Study

“…Previous research has looked into the role of oxidative stress in the progression of DR. It is also stated that oxidative stress increases as a result of duration of DM, overweight/obesity and central obesity, and lower HDL cholesterol and TG:HDL ratio, and accordingly affects the development of DR. [61][62][63]…”

Correlation between Imaging Morphological Findings and Laboratory Biomarkers in Patients with Diabetic Macular Edema

“…Moreover, it has been shown that patients with DME have increased levels of proinflammatory mediators in aqueous humor com-pared to non-DME cases [8], while there is a controversy whether the pathophysiology of DME is mainly attributed to such systemic affection or to a local intraocular response. Of note, several studies have shown that elevated serum lipids, including cholesterol and low-density lipoprotein (LDL), demonstrated a significant association with retinal hard exudates and formation of DME [9][10][11][12], while elevated IL-6 has also been correlated with diffuse retinal thickness or severity of DME [13,14].…”