Effect of intravitreal dexamethasone implant on intraocular inflammatory mediators in diabetic macular edema

Session Details

Session Title: Free Paper Session 16: Vascular Diseases & Diabetic Retinopathy IV

Session Date/Time: Friday 08/09/2017 | 16:30-18:00

Paper Time: 17:30

Venue: Room 114

First Author: : M.Figueras Roca SPAIN

Co Author(s): :    B. Molins   A. Sala-Puigdollers   J. Zarranz-Ventura   M. Alforja   J. Torras   A. Adan              

Abstract Details

Purpose:

To assess changes in the aqueous humour (AH) concentration of several inflammatory mediators following dexamethasone intravitreal implant injection for diabetic macular edema (DME).

Setting:

Retina Clinic of a tertiary referral Hospital (Hospital Clínic de Barcelona, Barcelona, Spain).

Methods:

Prospective interventional case series study. Study population: 10 eyes of 8 patients which met strict inclusion criteria on foveal-involving DME and cataract. Exclusion criteria included proliferative diabetic retinopathy, glaucoma or uncontrolled intraocular pressure, previous ocular surgery, and prior intravitreal injection of any kind within 6 months. Intervention: anterior chamber tap with AH sampling was performed sequentially at implant injection time (baseline, T1); during phacoemulsification and intraocular lens implantation 8 weeks afterwards (T2); and whenever repeated injection of the implant was required due to DME relapse (T3). Main outcome measure was set on changes between baseline (T1) and different time points (T2, T3) in AH levels of several inflammatory mediators: interferon (IFN)-γ, interleukin (IL)-1β, IL-3, IL-6, IL-8, IL-10, monocyte chemoattractant protein (MCP)-1, interferon gamma-induced protein (IP)-10, tumour necrosis factor (TNF)-α and vascular endothelial growth factor (VEGF).

Results:

AH levels of IL-6, IL-8, MCP-1 and IP-10 increased at DME relapse time point (T3) compared to both baseline (T1) and eight weeks after injection (T2) time points with the following significant changes: IL-6 (T1 p<0.001, T2 p=0.01), IL-8 (T1 p<0.001, T2 p<0.001), MCP-1 (T1 p<0.001, T2 p<0.001) and IP-10 (T1 p<0.001, T2 p<0.001). In addition, AH IP-10 levels also significantly decreased at T2 compared to T1 (p=0.002). IL-3, TNF-α and VEGF AH levels did not statistically change between study time points and IL-1β, IL-10 and IFN-γ did not reach detection level.

Conclusions:

IL-6, IL-8, MCP-1 and IP-10 could be considered as consistent intraocular driving actors of DME evolution with intravitreal dexamethasone implant treatment. Furthermore, IP-10 AH levels seemed to be directly correlated with such implant pharmacokinetics. More studies are warranted in order to fully understand this treatment effect on intraocular inflammatory mediators.

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