PMID- 31736269 OWN - NLM STAT- MEDLINE DCOM- 20210331 LR - 20230113 IS - 1755-3768 (Electronic) IS - 1755-375X (Print) IS - 1755-375X (Linking) VI - 98 IP - 4 DP - 2020 Jun TI - Aqueous humour cytokine changes during a loading phase of intravitreal ranibizumab or dexamethasone implant in diabetic macular oedema. PG - e407-e415 LID - 10.1111/aos.14297 [doi] AB - PURPOSE: To determine the effect of intravitreal ranibizumab and a dexamethasone implant on aqueous humour cytokine, protein and enzyme levels and to correlate findings to morphologic and functional changes. METHODS: In a prospective, randomized, controlled, double-blind study, patients with clinically significant diabetic macular oedema (CSME) were randomly allocated to receive either monthly intravitreal injections of ranibizumab (Lucentis, Novartis Pharma) or a single dexamethasone implant (Ozurdex, Pharm-Allergan) at baseline (BL). Aqueous humour samples were collected at BL and weeks 2, 8 and 20. RESULTS: The study included 18 eyes of 18 patients. In the dexamethasone implant group, soluble intercellular adhesion molecule 1 (sICAM-1) (weeks 2 and 8), CXCL9/monokine induced by gamma interferon (MIG) (weeks 2 and 8), soluble vascular cell adhesion protein 1 (sVCAM-1) (weeks 2 and 8) and monocyte chemo-attractant protein 1 (MCP-1) (week 2) levels were significantly decreased compared with baseline. In the ranibizumab group, placental growth factor (PIGF) (week 2) and vascular endothelial growth factor (VEGF) (week 2 and 8) levels were significantly decreased compared with baseline. No significant changes in central retinal thickness (CRT) or Early Treatment Diabetic Retinopathy Study (ETDRS) best corrected visual acuity (BCVA) were observed in the Ozurdex group at any time-points. ETDRS scores significantly increased at week 20 (84.88 +/- 8.88 letters) compared with baseline (74.78 +/- 14.85 letters), and the CRT decreased significantly at week 4 (381.00 +/- 114.64 mum) compared with baseline (440 +/- 144 mum) in the Lucentis group. CONCLUSION: The dexamethasone implant affected the aqueous cytokines and proteins MCP-1, sICAM-1, sVCAM-1 and MIG, whereas ranibizumab treatments reduced VEGF and PIGF levels. Morphological changes may diverge from cytokine changes. Results may indicate a rationale for a combination therapy for CSME using both agents, the dexamethasone implant and repeatedly administered ranibizumab injections. CI - (c) 2019 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation. FAU - Podkowinski, Dominika AU - Podkowinski D AUID- ORCID: 0000-0001-9656-3067 AD - Department of Ophthalmology and Optometry, Kepler University Clinic, Linz, Austria. AD - Johannes Kepler University, Linz, Austria. FAU - Orlowski-Wimmer, Eva AU - Orlowski-Wimmer E AD - Department of Ophthalmology and Optometry, Kepler University Clinic, Linz, Austria. FAU - Zlabinger, Gerhard AU - Zlabinger G AD - Division of Clinical and Experimental Immunology, Institute of Immunology, Medical University Vienna, Vienna, Austria. FAU - Pollreisz, Andreas AU - Pollreisz A AD - Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria. FAU - Mursch-Edlmayr, Anna-Sophie AU - Mursch-Edlmayr AS AUID- ORCID: 0000-0003-2218-5897 AD - Department of Ophthalmology and Optometry, Kepler University Clinic, Linz, Austria. AD - Johannes Kepler University, Linz, Austria. FAU - Mariacher, Siegfried AU - Mariacher S AD - Department of Ophthalmology and Optometry, Kepler University Clinic, Linz, Austria. AD - Johannes Kepler University, Linz, Austria. FAU - Ring, Michael AU - Ring M AD - Center for Medical Research, Johannes Kepler University, Linz, Austria. FAU - Bolz, Matthias AU - Bolz M AD - Department of Ophthalmology and Optometry, Kepler University Clinic, Linz, Austria. AD - Johannes Kepler University, Linz, Austria. LA - eng GR - Allergan/ PT - Journal Article PT - Randomized Controlled Trial DEP - 20191117 PL - England TA - Acta Ophthalmol JT - Acta ophthalmologica JID - 101468102 RN - 0 (Angiogenesis Inhibitors) RN - 0 (Cytokines) RN - 0 (Glucocorticoids) RN - 0 (Vascular Endothelial Growth Factor A) RN - 7S5I7G3JQL (Dexamethasone) RN - ZL1R02VT79 (Ranibizumab) SB - IM MH - Aged MH - Angiogenesis Inhibitors/administration & dosage MH - Aqueous Humor/*metabolism MH - Cytokines/*metabolism MH - Dexamethasone/*administration & dosage MH - Diabetic Retinopathy/complications/diagnosis/*drug therapy MH - Dose-Response Relationship, Drug MH - Double-Blind Method MH - Female MH - Follow-Up Studies MH - Glucocorticoids/administration & dosage MH - Humans MH - Intravitreal Injections MH - Macula Lutea/pathology MH - Macular Edema/diagnosis/*drug therapy/etiology MH - Male MH - Middle Aged MH - Prospective Studies MH - Ranibizumab/*administration & dosage MH - Tomography, Optical Coherence/methods MH - Treatment Outcome MH - Vascular Endothelial Growth Factor A/antagonists & inhibitors MH - *Visual Acuity PMC - PMC7318694 OTO - NOTNLM OT - aqueous humour cytokines OT - dexamethasone implant OT - diabetic macular oedema OT - ranibizumab EDAT- 2019/11/19 06:00 MHDA- 2021/04/01 06:00 PMCR- 2020/06/26 CRDT- 2019/11/19 06:00 PHST- 2019/04/11 00:00 [received] PHST- 2019/10/11 00:00 [accepted] PHST- 2019/11/19 06:00 [pubmed] PHST- 2021/04/01 06:00 [medline] PHST- 2019/11/19 06:00 [entrez] PHST- 2020/06/26 00:00 [pmc-release] AID - AOS14297 [pii] AID - 10.1111/aos.14297 [doi] PST - ppublish SO - Acta Ophthalmol. 2020 Jun;98(4):e407-e415. doi: 10.1111/aos.14297. Epub 2019 Nov 17.