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Changes of aqueous vascular endothelial growth factor and interleukin-6 after intravitreal triamcinolone for branch

Sung P Park¹, Jae K Ahn

¹Department of Ophthalmology, Hallym University Medical School, Seoul, Korea.

Clinical & Experimental Ophthalmology

|March 13, 2009

Abstract

Background:

To investigate sequential changes of aqueous vascular endothelial growth factor (VEGF) and interleukin (IL)-6 in macular oedema secondary to branch retinal vein occlusion after single intravitreal injection of triamcinolone acetonide (IVTA).

Methods:

We recruited 10 healthy controls and 30 patients at Chonnam National University Hospital, Gwangju, Korea. Aqueous and plasma levels of VEGF and IL-6 were measured by enzyme-linked immunosorbent assay at the time of IVTA and 3 months later. Non-response to IVTA was defined as showing persistent macular oedema based on a reduction of central macular thickness by less than 20% from baseline measurements by optical coherence tomography and vision improvement by less than 0.3 logMAR. Fluorescein angiography was performed 6 months after IVTA. We compared aqueous levels of VEGF and IL-6 between responders and non-responders.

Results:

The aqueous levels of VEGF and IL-6 were significantly higher in 12 non-responders than in 18 responders at baseline measurements (511 +/- 245 pg/mL vs. 230 +/- 108 pg/mL, P < 0.001; 38 +/- 31 pg/mL vs. 16 +/- 13 pg/mL, P < 0.001, respectively). Aqueous levels of VEGF were still higher in non-responders (312 +/- 64 pg/mL) 3 months after IVTA, and aqueous levels of VEGF in responders returned to normal (86 +/- 21 pg/mL, P < 0.001). Aqueous levels of IL-6 normalized in all patients 3 months after IVTA. Fluorescein angiography revealed that non-responders showed higher frequencies of macular ischaemia and ischaemic branch retinal vein occlusion.

Conclusions:

IL-6-independent VEGF secretion may contribute to persistent macular oedema associated with ischaemic BRVO after IVTA.

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