Aqueous Cytokine Expression and Higher Order OCT Biomarkers: Assessment of the Anatomic-Biologic Bridge in the IMAGINE DME Study.
Adult
Aged
Angiogenesis Inhibitors
/ administration & dosage
Aqueous Humor
/ metabolism
Biomarkers
/ metabolism
Cytokines
/ biosynthesis
Diabetic Retinopathy
/ diagnosis
Female
Humans
Intravitreal Injections
Macula Lutea
/ pathology
Macular Edema
/ diagnosis
Male
Middle Aged
Tomography, Optical Coherence
/ methods
Vascular Endothelial Growth Factor A
/ antagonists & inhibitors
Visual Acuity
Journal
American journal of ophthalmology
ISSN: 1879-1891
Titre abrégé: Am J Ophthalmol
Pays: United States
ID NLM: 0370500
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
03
05
2020
revised:
29
08
2020
accepted:
31
08
2020
pubmed:
9
9
2020
medline:
17
3
2021
entrez:
8
9
2020
Statut:
ppublish
Résumé
To identify biomarkers for predicting response to anti-vascular endothelial growth factor (VEGF) therapy in diabetic macular edema (DME) and evaluate any links between cytokine expression and optical coherence tomography (OCT) phenotype. The IMAGINE is a post hoc image analysis and cytokine expression assessment of the Efficacy & Safety Trial of Intravitreal Injections Combined With PRP for CSME Secondary to Diabetes Mellitus (DAVE) randomized clinical trial. Subjects were categorized as anatomical responders or nonresponders, and within the responder group as rebounders and non-rebounders based on quantitative, longitudinal OCT criteria. Retinal layer and fluid features were extracted using an OCT machine-learning augmented segmentation platform. Responders were further sub-classified by rapidity of response. Aqueous concentrations of 54 cytokines were measured at multiple timepoints. Expression was compared between responder groups and correlated with OCT imaging biomarkers. Of the 24 eyes studied, 79% were anatomical responders with 38% super responders, 17% early responders, and 25% slow responders. Twenty-one percent were nonresponders. Super responders had increased baseline vascular endothelial growth factor (VEGF) (880.0 pg/mL vs 245.4 pg/mL; P = .012) and decreased monocyte chemotactic protein-1 (MCP-1) (513.3 pg/mL vs 809.5 pg/mL; P = .0.042) concentrations compared with nonresponders. Interleukin-6 (-24.9 pg/mL vs 442.8 pg/mL; P = .032) concentrations increased among nonresponders during therapy. VEGF concentrations correlated with central subfield thickness (r = 0.49; P = .01). Panmacular retinal volume correlated with increased interleuckin-6 (r = 0.47; P = .02) and decreased MCP-1 (r = -0.45; P = .03). Matrix metallopeptidase-1 correlated with subretinal fluid volume (r = 0.50; P = .01). OCT imaging biomarkers correlated with both intraocular cytokines and responsiveness to anti-VEGF therapy, which indicated a possible link to underlying pathways and their relevance to DME prognosis. Baseline concentrations of VEGF and MCP-1 are associated with anatomic response to anti-VEGF therapy.
Identifiants
pubmed: 32896498
pii: S0002-9394(20)30484-0
doi: 10.1016/j.ajo.2020.08.047
pmc: PMC9719825
mid: NIHMS1627411
pii:
doi:
Substances chimiques
Angiogenesis Inhibitors
0
Biomarkers
0
Cytokines
0
Vascular Endothelial Growth Factor A
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
328-339Subventions
Organisme : NEI NIH HHS
ID : K23 EY022947
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
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