Correlation Between Levels Of Cytokines In Aqueous Humor And The Prognosis Of Anti-VEGF Therapy Of Diabetic Retinopathy Patients

Objective:Objective to study the Correlation between levels of cytokines in aqueous humor and the prognosis of Anti-VEGF Therapy of Diabetic retinopathy Patients,to explore the effect of anti-VEGF on the prognosis of DR surgery,and to guide clinical practice.Methods:A prospective analysis was performed on 25 DR（IV）patients who were treated in our hospital from October 2020 to October 2021.According to whether 25G minimally Parsplanavitrectomy（PPV）was combined with anti-VEGF therapy,they were divided into anti-VEGF group（15 cases with 15 eyes）and control group（10cases with 10 eyes）.The baseline data,clinical surgical indicators and postoperative indicators of each patient in the two groups were collected and recorded:preoperative baseline data included age,gender,history of hypertension,type of diabetes,duration of diabetes,and glycated hemoglobin level;baseline eye data included eye gender,Intraocular pressure,preoperative average visual acuity;clinical operation indicators include the time of vitrectomy performed by the same operator,the degree of intraoperative bleeding,the number of retinal coagulation,the occurrence of iatrogenic retinal breaks,and the number of eyes filled with silicone oil/air;postoperative indicators Including postoperative visual acuity improvement,postoperative high intraocular pressure,postoperative macular edema,postoperative vitreous rebleeding.In the anti-VEGF group,100 ul of aqueous humor was drawn before intravitreal injection of conbercept（IVC）and PPV;in the control group,100ul of aqueous humor was drawn before PPV.The concentration of cytokines in aqueous humor was detected by flow-liquid multiplexed protein quantification technique(BD^TMCBA).To compare the correlation of differential surgical indicators and differential cytokine levels.statistical analysis was peformed on the obtained data with SPSS 26.0 software.Results:1.The vitrectomy time in the anti VEGF group was shorter than that in the control group;The degree and rate of intraoperative bleeding were lower than those in the control group;The times of retinal electrocoagulation were lower than those in the control group;The incidence of postoperative macular edema was lower than that in the control group（P<0.05）.2.Compared with that before anti VEGF injection,the levels of VEGF and FGF in aqueous humor decreased and the level of IL-8 increased after IVC in the anti VEGF group（P<0.005）.Compared with the control group,the cytokines in IVC anterior aqueous humor of anti VEGF group had no significant difference except IFN gamma,MCP-3 and HGF（P<0.05）.3.IL-8 was positively correlated with vitrectomy time and intraoperative bleeding（r=0.734,0.560,P<0.01）;VEGF was positively correlated with intraoperative bleeding and electrocoagulation times（r=0.671,0.519,P<0.05）;FGF was positively correlated with the times of electrocoagulation（r=0.537,P<0.05）,and negatively correlated with postoperative macular edema（r=0.664,P<0.01）.Conclusion:1.Intravitreal injection of conbercept in DR（IV）patients can shorten the time of vitrectomy,reduce the degree of intraoperative bleeding,reduce the number of retinal electrocoagulation and the incidence of postoperative macular edema.2.The intravitreal injection of conbercept in DR（IV）patients can affect the levels of VEGF,IL-8 and FGF in aqueous humor.3.Conbercept may shorten the operation time,reduce intraoperative bleeding and postoperative macular edema by affecting the levels of VEGF,IL-8 and FGF in aqueous humor of patients with DR（IV）,thereby improving the surgical efficacy and prognosis.