The Outcome Of DME And Its Correlation With IL-6,TNF-α And VEGF In Aqueous Solution After IVC

Purpose:This study aimed to investigate the concentrations of Interleukin-6（IL-6）,Tumor necrosis factor-α（TNF-α）and Vascular endothelial growth factor（VEGF）in diabetic macular edema（DME）eyes before and during therapy with the intravitreal injection of conbercept（IVC）and to identify associations with disease activity.Methods:Prospective study.A total of 40 eyes of 40 patients with diabetic macular edema admitted to the First Affiliated Hospital of Bengbu Medical College from July 2020 to July 2021 were selected.All DME patients agreed to receive intravitreal injection of 0.05 mL Compaserib,and aqueous fluid was collected before the first and second IVC injection.The concentrations of interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）and vascular endothelial growth factor（VEGF）in aqueous solution were determined by enzyme linked immunosorbent assay（ELISA）kit.All DME patients were examined for best corrected visual acuity（BCVA）using the international standard logarithmic visual acuity chart before the two IVC operations.The results were expressed as logMAR visual acuity,and the thickness of macular fovea（CMT）was examined using optical coherence tomography（OCT）.The concentrations of IL-6,TNF-α and VEGF in aqueous humor before two IVC operations were compared with the changes of CMT and BCVA,and the correlation between these observation indicators was analyzed.The comparison before and after treatment was performed by paired sample T test.Correlation analysis was conducted by Pearson correlation analysis.Results:1.The levels of IL-6 and VEGF were positively correlated with CMT（r=0.652,0.847,P<0.05）.2.One month after IVC surgery,the intraocular IL-6 and VEGF concentrations of DME patients were（21.71 ± 13.95）pg/mL and（128.53 ± 75.51）pg/mL,significantly lower than baseline levels（P<0.001）.TNF-α concentration was（4.90±4.57）pg/mL,and no significant change was observed before and after operation（P>0.05）.3.One month after IVC operation,BCVA（0.24±0.15）was significantly higher than that before treatment（0.35±0.20）（P=0.001）,and CMT was significantly lower（P=0.002）,from（479±116）μm to（375±84）μm.4.The concentrations of IL-6 and VEGF were positively correlated with CMT before IVC in DME patients（r=0.652,0.847,P<0.05）,and the concentrations of IL-6 and VEGF in aqueous fluid before and after IVC were also positively correlated（R=0.677,0.481,P<0.05）.5.Before and after IVC surgery,the decrease of VEGF in DME patients was significantly positively correlated with the decrease of CMT（r=0.531,P=0.016）,while there was no significant correlation between the decrease of VEGF and the improvement of BCVA（r=0.208,P=0.197）.There was no significant correlation between CMT decrease and BCVA improvement（r=0.054,P=0.742）.Conclusion:1.The levels of IL-6 and VEGF in aqueous humor were correlated with the occurrence and development of DME.2.Intravitreal injection of conbercept（IVC）could bring down the expression of IL-6 and VEGF in aqueous humor,thinened CMT,alleviated macular edema,and improved visual acuity,but had no significant effect on TNF-α.3.CMT is associated with VEGF levels in aqueous humor.