Study On Aqueous Humor And Serum Inflammatory Cytokines In Idiopathic Choroidal Neovascularization

PurposeTo investigate correlations between the levels of aqueous humor and serum inflammatory cytokines in patients with idiopathic choroidal vascularization(ICNV)and clinical parameters,and to determine the effect of intravitreal injection of ranibizumab(IVR)on cytokine levels.MethodsThis study is divided into two parts.In the first part,39 ICNV patients and 28 Senile or congenital cataract patients were recruited and we compared the levels of cytokines in aqueous humor in this part.In the second part,32 ICNV patients whose venous blood was obtained served as experimental group,30 age and sex matched healthy controls were recruited and we compared the level of cytokines in serum in this part.They all received comprehensive ophthalmological examinations before the study.Aqueous humor and venous blood obtained before the patients received IVR.A second aqueous humor obtained when patients received the second injection.Using a multiplex bead analysis,the levels of 27 types of cytokines in aqueous humor were measured.In serum,VEGF and 6 types of cytokines elevated in aqueous humor were also measured.Cytokine profiles were correlated with visual acuity(VA),Central Retinal Thickness(CRT)and Lesion Area(LA)and we also compared the aqueous humor cytokines profiles before and after the first injection.ResultsIn aqueous humor,the mean IL-2,IL-10,IL-15,IL-17,basic FGF,and GM-CSF levels in the ICNV group were significantly elevated compared with controls.Besides,The levels of IL-10,IL-17,GM-CSF,and VEGF were positively correlated with LA.In addition,IVR significantly reduced the levels of VEGF,IL-2,IL-10,basic FGF,and IL-12,however,the level of IL-6 were significantly increased.In serum,the mean levels of IL-2,IL-10,IL-17,basic FGF,and VEGF in the ICNV group were significantly elevated compared with controls.The serum level of GM-CSF is the only cytokine positively correlated with CRT.The serum level of IL-17 is the only cytokine positively correlated with LA.Significant changes in visual acuity and central retinal thickness were observed after IVR.ConclusionOur study suggests that IL-17 and some other inflammatory cytokines related inflammatory processes may play a role in the etiology of ICNV and the elevated serum levels of IL-17 may be a systemic risk factor for ICNV formation.