视网膜静脉阻塞继发黄斑水肿患者基线房水细胞因子水平与抗VEGF疗效的相关性  

Correlation between baseline aqueous humor cytokine levels and anti-vascular endothelial growth factor treatment in patients with macular edema secondary to retinal vein obstruction

作　　者：黄颖[1] 陈佳沁 蒋沁[1] 姚进[1] HUANG Ying;CHEN Jiaqin;JIANG Qin;YAO Jin(The Affiliated Eye Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京医科大学附属眼科医院,江苏省南京市210000

出　　处：《眼科新进展》2024年第1期39-43,共5页Recent Advances in Ophthalmology

基　　金：国家自然科学基金(编号:82271107)。

摘　　要：目的利用基线房水细胞因子预测视网膜静脉阻塞继发黄斑水肿(RVO-ME)患者抗血管内皮生长因子(VEGF)治疗3个月后黄斑中心凹厚度(CMT)和最佳矫正视力(BCVA)的改善情况。方法选择2021年10月至2023年1月在南京医科大学附属眼科医院首诊为RVO-ME的患者30例(30眼),在抗VEGF药物注射前行前房穿刺收集房水。采用Luminex液相芯片技术测定患者房水中VEGF、细胞间黏附分子-1(ICAM-1)、白细胞介素(IL)和干扰素-γ(IFN-γ)等11种细胞因子的水平。分析RVO-ME患者基线房水细胞因子水平与CMT、BCVA(logMAR)以及其变化值(基线与抗VEGF治疗3个月后差值)的相关性;在基线时与抗VEGF治疗3个月后分别分析CMT和BCVA(logMAR)间的相关性。CMT、BCVA应答者定义为从基线到抗VEGF治疗3个月后CMT、BCVA(logMAR)减少50%及以上的患者,使用Logistic回归模型分析基线房水细胞因子与RVO-ME患者抗VEGF治疗3个月后成为CMT或BCVA应答者的关系。结果与基线时相比,抗VEGF治疗3个月后RVO-ME患者CMT明显下降,BCVA明显改善(均为P<0.001)。RVO-ME患者基线时、抗VEGF治疗3个月后CMT与BCVA(logMAR)之间均呈正相关(P=0.026、0.002)。基线时,RVO-ME患者VEGF、IL-8水平与CMT均呈正相关(P=0.032、0.035);IL-6、IL-8水平与BCVA(logMAR)均呈正相关(P=0.018、0.002)。RVO-ME患者基线IL-8水平与CMT变化值呈负相关(P=0.024)。Logistic回归分析结果表明,基线ICAM-1水平升高增加RVO-ME患者抗VEGF治疗3个月后BCVA无应答的风险(P=0.023)。结论基线IL-8与ICAM-1可能是RVO-ME抗VEGF治疗后CMT及BCVA改善的预测因子。Objective To analyze the effect of baseline cytokines in aqueous humor in predicting the improvement of the central macular thickness(CMT)and best corrected visual acuity(BCVA)of patients with macular edema secondary to retinal vein obstruction(RVO-ME)after anti-vascular endothelial growth factor(VEGF)treatment for 3 months.Methods Totally 30 eyes of 30 patients initially diagnosed with RVO-ME in the Affiliated Eye Hospital of Nanjing Medical University from October 2021 to January 2023 were enrolled.Aqueous humor was collected by anterior chamber puncture before the anti-VEGF drug injection.The levels of 11 cytokines in aqueous humor,including VEGF,intercellular adhesion molecule(ICAM)-1,interleukins(ILs)and interferon-γ(IFN-γ),were measured by Luminex xMAP technology.The correlation between baseline aqueous humor cytokine levels and CMT,BCVA(logMAR)as well as their changes(difference between baseline and anti-VEGF treatment for 3 months)in RVO-ME patients was analyzed;the correlation between CMT and BCVA(logMAR)was analyzed at baseline and 3 months after anti-VEGF treatment.CMT and BCVA responders were defined as patients with 50%or more reduction in CMT and BCVA(logMAR)from baseline to the third month.A Logistic regression model was used to analyze the relationship between baseline aqueous humor cytokines and RVO-ME patients becoming CMT or BCVA responders after 3 months of anti-VEGF treatment.Results Compared with baseline,the CMT significantly decreased and BCVA significantly improved in RVO-ME patients after anti-VEGF treatment for 3 months(both P<0.001).The CMT was positively correlated with BCVA(logMAR)of RVO-ME patients at baseline and after anti-VEGF treatment for 3 months(P=0.026,0.002).At baseline,the levels of VEGF and IL-8 of RVO-ME patients were positively correlated with CMT(P=0.032,0.035);the levels of IL-6 and IL-8 were positively correlated with BCVA(logMAR)(P=0.018,0.002).The baseline IL-8 level in RVO-ME patients was negatively associated with the change in CMT(P=0.024).Logistic regression

关 键 词：视网膜静脉阻塞 黄斑水肿 房水 细胞因子 黄斑中心凹厚度 最佳矫正视力 

分 类 号：R774.5[医药卫生—眼科]