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목적 : To investigate the changes in aqueous inflammatory and angiogenic cytokine levels after intravitreal bevacizumab and subtenon triamcinolone injection for reducing foveal thickness in diabetic macular edema (DME).
방법 : 24 eyes of 23 patients with DME and 15 eyes of 13 patients undergoing cataract surgery participated in this study. Each patient with DME randomly received an intravitreal injection of either 1.25 mg bevacizumab or 20 mg triamcinolone subtenon injection additionally. Aqueous humor samples were obtained before and 4 weeks after the intravitreal injection in the DME group and before the surgery in the control group. Aqueous concentrations of IL-6, IL-8, IP-10, MCP-1, PDGF-AA, and VEGF were measured by multiplex bead assay.
결과 : Before the administration of the drugs, aqueous levels of IL-6, IL-8, IP-10, MCP-1, PDGF-AA and VEGF were significantly higher in the DME group than in the control group. After intravitreal injection, foveal thickness was more decreased in the bevacizumab plus triamcinolone acetonide (IVBe+subTA) group compared with the bevacizumab (IVBe) group. IL-8, MCP-1, and VEGF were significantly decreased in the IVBe+subTA group, but only VEGF in the IVBe group. Between the IVBe+subTA group and the IVBe group, no significant differences in the changes of VEGF levels were noted.
결론 : Intravitreal bevacizumab and subtenon triamcinolone injection reduces inflammatory cytokines in DME, while bevacizumab has no influence on other cytokines. No differences in the therapeutic effect were noted between an inhibition of inflammatory cytokines and an inhibition of VEGF only.
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