Aqueous Humor Cytokine Levels and Anatomic Response to Intravitreal Ranibizumab in Diabetic Macular Edema

Area of Science:

• Ophthalmology
• Medical Biomarkers
• Diabetic Retinopathy

Background:

• Diabetic macular edema (DME) treatment response to anti-vascular endothelial growth factor (VEGF) varies significantly.
• Identifying predictive biomarkers for anti-VEGF therapy is crucial for optimizing DME management.

Purpose of the Study:

• To analyze changes in aqueous humor cytokine levels following intravitreal ranibizumab in DME patients.
• To determine if baseline aqueous cytokine levels correlate with anatomic response to ranibizumab therapy.

Main Methods:

• A prospective cohort study involving 48 participants with center-involving DME receiving monthly ranibizumab injections.
• Aqueous humor samples collected at baseline and 2 months for multiplex immunoassay of various cytokines.
• Spectral-domain optical coherence tomography (SD-OCT) assessed anatomic changes at 3 months.

Main Results:

• Ranibizumab treatment led to decreased levels of ICAM-1, VEGF, placental growth factor, IL-6, and monocyte chemoattractant protein 1 at 2 months.
• Elevated baseline aqueous ICAM-1 correlated with a favorable anatomic response (reduced macular volume).
• Elevated baseline aqueous VEGF correlated with a less favorable anatomic response and lower likelihood of central subfield thickness reduction.

Conclusions:

• Baseline aqueous ICAM-1 and VEGF levels are associated with anatomic response to ranibizumab in DME.
• These findings may aid in predicting treatment outcomes and personalizing DME management strategies.