Association between inflammatory cytokines in the aqueous humor and hyperreflective foci on optical coherence tomography in patients with neovascular age-related macular degeneration and polypoidal choroidal vasculopathy

Jianbo Mao; Nuo Chen; Shian Zhang; Yuyan Fang; Zicheng Zheng; Sulan Wu; Xin Ye; Yijing Chen; Yiqi Chen; Lijun Shen

doi:10.3389/fmed.2022.973025

Association between inflammatory cytokines in the aqueous humor and hyperreflective foci on optical coherence tomography in patients with neovascular age-related macular degeneration and polypoidal choroidal vasculopathy

Front Med (Lausanne). 2022 Sep 23:9:973025. doi: 10.3389/fmed.2022.973025. eCollection 2022.

Authors

Jianbo Mao^{1

2}, Nuo Chen², Shian Zhang¹, Yuyan Fang², Zicheng Zheng³, Sulan Wu², Xin Ye², Yijing Chen², Yiqi Chen^{1

2}, Lijun Shen^{1

2}

Affiliations

¹ Center for Rehabilitation Medicine, Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hangzhou, China.
² School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
³ Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.

Abstract

Purpose: To investigate the associations between cytokine levels in the aqueous humor (AH) and hyperreflective foci (HF) on spectral-domain optical coherence tomography (SD-OCT) in neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV).

Methods: The prospective study included 63 eyes with nAMD, 44 with PCV, and 43 with cataracts (Controls). AH samples were obtained before anti-vascular endothelial growth factor (VEGF) therapy or cataract surgery. Cytokines interleukin 6 (IL-6), IL-8, IL-10, interferon-inducible protein 10 (IP-10), monocyte chemotactic protein 1 (MCP-1), and VEGF were measured by multiplex bead assay. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and the number of HF were evaluated at baseline and 1 month after anti-VEGF treatment.

Results: No significances difference in IL-6 and IL-8 levels were noted among the three groups (P = 0.370 and P = 0.067). VEGF, IP-10, and IL-10 levels were significantly higher in nAMD and PCV groups than in Controls (all P < 0.05). In nAMD, HF was positively correlated with VEGF (r _s = 0.300, P = 0.025) and in eyes with HF group, VEGF and IL-10 were significantly higher than those without HF (P = 0.008 and P = 0.022). In PCV, no correlation was observed between HF and cytokines (all P > 0.05). After anti-VEGF treatment, patients with HF in nAMD and PCV were predisposed to worse visual outcomes (P = 0.022 and P = 0.015) and a significantly greater reduction in CMT (P = 0.001 and P = 0.057). And nAMD patients with HF were more sensitive to anti-VEGF treatment than those without HF (P = 0.029).

Conclusions: In the nAMD group, HF was positively correlated with VEGF. Patients in nAMD with HF had elevated levels of VEGF and IL-10 and responded favorably to anti-VEGF. HF might serve as an inflammatory biomarker and a predictive factor for therapeutic efficacy in patients with nAMD.

Keywords: aqueous humor; cytokine; hyperreflective foci; neovascular age-related macular degeneration; polypoidal choroidal vasculopathy; spectral-domain optical coherence tomography.