Study On The Relationship Between The Levels Of Cytokines In Serum,aqueous Humor And Vitreous Fluid And Idiopathic Macular Epiretinal Membrane

Objective: to explore the relationship between the expression of cytokines in serum,anterior chamber fluid and vitreous fluid and idiopathic macular epiretinal membrane(IMEM).Methods: from January 2018 to October 2019,32 patients(32 eyes)with IMEM and21 patients(21 eyes)with idiopathic macular hole(IMH)in our hospital were treated with surgery.The patients with IMEM were the experimental group and the control group with IMH.The macular fovea thickness(MFT),the best corrected visual acuity(BCVA)and the levels of interleukin-2(IL-2),interleukin-4(IL-4),interleukin-6(IL-6),interleukin-10(IL-10),interleukin-17A(IL-17A),tumor necrosis factor-?(TNF-?),interferon-?(INF-?)and vascular endothelial growth factor(VEGF)in serum were measured before operation in the trial group.The operation was performed with routine three-channel vitrectomy of the pars plana of the ciliary body,removal of macular epiretinal membrane and internal limiting membrane,combined with phacoemulsification and intraocular lens implantation.Anterior chamber fluid and vitreous fluid were collected during operation to detect cytokines.The MFT and BCVA of the patients at 3 months after operation were counted.In the control group,blood was collected before operation,and anterior chamber fluid and vitreous fluid were collected during operation to detect the levels of cytokines(IL-2,IL-4,IL-6,IL-10,IL-17 A,TNF-?,IFN-?,VEGF).The above data were collected for statistical analysis.Results: there was no significant difference in the levels of IL-2,IL-4,IL-6,IL-10,IL-17 A,TNF-?,IFN-? and VEGF in vitreous fluid between IMEM and IMH patients.The levels of cytokines in vitreous fluid and serum of patients with IMEM showed no significant difference in IL-2,IL-4,IL-17 A,TNF-? and IFN-?,but significant differences in IL-6,IL-10 and VEGF(p < 0.001).The levels of cytokines in vitreous fluid and serum of IMH patients showed no significant difference in IL-2,IL-4,IL-17 A,TNF-?,IFN-? and VEGF,but there was significant difference in IL-6 and IL-10.The levels of cytokines in vitreous fluid and anterior chamber fluid of patients with IMEM showed that the overall distribution of IL-2,IL-4,IL-10,IL-17 A,TNF-? and IFN-?was the same,but there was significant difference between IL-6 and VEGF.The levels of cytokines(IL-2,IL-4,IL-6,IL-10,IL-17 A,TNF-?,IFN-?,VEGF)in vitreous fluid of patients with IMEM were correlated with BCVA and MFT before and after operation.In some patients with 72%IMEM,BCVA and MFT were improved,BCVA(logMAR)increased by 0.24 ±0.25 and MFT decreased by 74.77 ±89.20 ? m.Three months after the above-mentioned surgical treatment,the increase of BCVA(t = 5.194,p < 0.001)and the decrease of macular fovea thickness(t = 4.591,p < 0.001)in IMEM patients were statistically significant compared with those before operation.There was a positive correlation between preoperative BCVA and postoperative BCVA(r = 0.428,p < 0.005),and there was a positive correlation between preoperative MFT and postoperative MFT(r = 0.601,p < 0.001).Conclusion:the level of IL-6 in vitreous fluid of patients with IMEM is significantly higher than that in serum,suggesting that there may be inflammatory reaction in vitreous fluid.For patients with IMEM,the levels of IL-2,IL-4,IL-10,IL-17 A,TNF-?and IFN-? in vitreous fluid may be evaluated by the level of these cytokines in anterior chamber fluid.The levels of IL-2,IL-4,IL-6,IL-10,IL-17 A,TNF-?,IFN-? and VEGF were not correlated with the prognosis of visual acuity and the severity of macular edema in patients with IMEM.There was no significant correlation between IL-17 A and the formation of IMEM.When exploring the correlation between some eye diseases and the level of cytokines in vitreous fluid,IMEM and IMH should be used as healthy control group.Surgery can improve the visual acuity and the thickness of macular fovea in most patients with IMEM.The better the preoperative BCVA,the better the prognosis of visual acuity 3 months after operation,the more serious the preoperative macular edema,and the worse the recovery of macular morphology 3 months after operation.