Neovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment

Pear Pongsachareonnont,1,2 Michael Ying Kit Mak,2 Cameron Paul Hurst,3 Wai-Ching Lam2,4 1Vitreo-Retinal Research Unit, Department of Ophthamology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; 2Department of Ophtha...

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Autores principales:	Pongsachareonnont P, Mak MYK, Hurst CP, Lam WC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Neovascular age-related macular degeneration choroidal neovascularization anti-VEGF non-responder poor responder ranibizumb and AMD Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/8eec404446fd4488a5b51318849488b8
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spelling	oai:doaj.org-article:8eec404446fd4488a5b51318849488b82021-12-02T08:08:49ZNeovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment1177-5483https://doaj.org/article/8eec404446fd4488a5b51318849488b82018-09-01T00:00:00Zhttps://www.dovepress.com/neovascular-age-related-macular-degeneration-intraocular-inflammatory--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Pear Pongsachareonnont,1,2 Michael Ying Kit Mak,2 Cameron Paul Hurst,3 Wai-Ching Lam2,4 1Vitreo-Retinal Research Unit, Department of Ophthamology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; 2Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine, Toronto, ON, Canada; 3Biostatistics Center, Department of Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 4Department of Ophthalmology, University of Hong Kong, Hong Kong, China Purpose: To determine the levels of interleukin (IL)-6, vascular endothelial growth factor-A, platelet-derived growth factor, placental growth factor (PLGF), and other cytokines in the aqueous fluid of patients with neovascular age-related macular degeneration who respond poorly to ranibizumab. Patients and methods: This is an observational, prospective study. Thirty-two eyes from 30 patients were included in the study: 11 patients who responded poorly to ranibizumab and were switched to aflibercept (AF group), 8 patients who received ranibizumab and photodynamic therapy (PDT group), and 13 patients who responded to ranibizumab (control group). Aqueous fluid samples were collected for analysis of cytokine levels at baseline and after 1, 2, and 3 months of treatment. The effect of treatment on cytokine levels was compared between the study groups and between different time points using a linear mixed-effect regression model. Results: In the AF group, there was an increase in vascular endothelial growth factor-C, IL-7, and angiopoeitin-2 levels (P=0.01) and a decrease in intercellular adhesion molecule and IL-17 levels (P=0.01) between baseline and 3 months. After adjustment for age, sex, race, and type of lesion at baseline, the PLGF level was higher (P=0.02) and the IL-7 level was lower (P=0.04) in the ranibizumab non-responder group than in the ranibizumab responder group. Conclusion: Switching from ranibizumab to aflibercept did not reduce intraocular levels of angiogenesis cytokines, but resulted in improvement of central subfield thickness. PLGF levels were higher in poor responders to ranibizumab. The response of lesions to medication might be related to the stage of choroidal neovascularization. Trial registration: www.ClinicalTrial.gov (NCT02218177c). Keywords: neovascular age-related macular degeneration, choroidal neovascularization, anti-VEGF non-responder, poor responder, ranibizumab and AMDPongsachareonnont PMak MYKHurst CPLam WCDove Medical PressarticleNeovascular age-related macular degenerationchoroidal neovascularizationanti-VEGF non-responderpoor responderranibizumb and AMDOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 12, Pp 1877-1885 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neovascular age-related macular degeneration choroidal neovascularization anti-VEGF non-responder poor responder ranibizumb and AMD Ophthalmology RE1-994
spellingShingle	Neovascular age-related macular degeneration choroidal neovascularization anti-VEGF non-responder poor responder ranibizumb and AMD Ophthalmology RE1-994 Pongsachareonnont P Mak MYK Hurst CP Lam WC Neovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment
description	Pear Pongsachareonnont,1,2 Michael Ying Kit Mak,2 Cameron Paul Hurst,3 Wai-Ching Lam2,4 1Vitreo-Retinal Research Unit, Department of Ophthamology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; 2Department of Ophthalmology and Vision Sciences, University of Toronto Faculty of Medicine, Toronto, ON, Canada; 3Biostatistics Center, Department of Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; 4Department of Ophthalmology, University of Hong Kong, Hong Kong, China Purpose: To determine the levels of interleukin (IL)-6, vascular endothelial growth factor-A, platelet-derived growth factor, placental growth factor (PLGF), and other cytokines in the aqueous fluid of patients with neovascular age-related macular degeneration who respond poorly to ranibizumab. Patients and methods: This is an observational, prospective study. Thirty-two eyes from 30 patients were included in the study: 11 patients who responded poorly to ranibizumab and were switched to aflibercept (AF group), 8 patients who received ranibizumab and photodynamic therapy (PDT group), and 13 patients who responded to ranibizumab (control group). Aqueous fluid samples were collected for analysis of cytokine levels at baseline and after 1, 2, and 3 months of treatment. The effect of treatment on cytokine levels was compared between the study groups and between different time points using a linear mixed-effect regression model. Results: In the AF group, there was an increase in vascular endothelial growth factor-C, IL-7, and angiopoeitin-2 levels (P=0.01) and a decrease in intercellular adhesion molecule and IL-17 levels (P=0.01) between baseline and 3 months. After adjustment for age, sex, race, and type of lesion at baseline, the PLGF level was higher (P=0.02) and the IL-7 level was lower (P=0.04) in the ranibizumab non-responder group than in the ranibizumab responder group. Conclusion: Switching from ranibizumab to aflibercept did not reduce intraocular levels of angiogenesis cytokines, but resulted in improvement of central subfield thickness. PLGF levels were higher in poor responders to ranibizumab. The response of lesions to medication might be related to the stage of choroidal neovascularization. Trial registration: www.ClinicalTrial.gov (NCT02218177c). Keywords: neovascular age-related macular degeneration, choroidal neovascularization, anti-VEGF non-responder, poor responder, ranibizumab and AMD
format	article
author	Pongsachareonnont P Mak MYK Hurst CP Lam WC
author_facet	Pongsachareonnont P Mak MYK Hurst CP Lam WC
author_sort	Pongsachareonnont P
title	Neovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment
title_short	Neovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment
title_full	Neovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment
title_fullStr	Neovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment
title_full_unstemmed	Neovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment
title_sort	neovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/8eec404446fd4488a5b51318849488b8
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Neovascular age-related macular degeneration: intraocular inflammatory cytokines in the poor responder to ranibizumab treatment

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