Changes Of Inflammatory Cytokines And VEGF In Intraocular Fluid In Patients With Proliferative Diabetic Retinopathy Under Different Fundus Phenotypes

Objective:To compare the concentration of cytokines in aqueous and vitreous of patients with proliferative diabetic retinopathy,and to compare the expression differences of inflammatory cytokines and vascular endothelial growth factor under different fundus phenotypes of PDR.Method:Patients with PDR who underwent pars plana vitrectomy(PPV)in the ophthalmology department of our hospital from June 2022 to December 2022 were collected and included in the experimental group(39 cases,39 eyes),divided into neovascularization group(19 cases,19 eyes)and fibroproliferative group(20cases,20 eyes).Non-diabetic patients who needed PPV surgery due to idiopathic macular hole,idiopathic macular membrane and retinal detachment were included in the control group(23 cases,23 eyes).The concentrations of interleukin-8(IL-8),monocyte chemoattractant protein-1(MCP-1)and VEGF in aqueous and vitreous were measured by enzyme-linked immunosorbent assay(ELISA).SPSS 26.0 software was used for statistical analysis of the obtained data.Result:1.Comparison of general dataThe total cholesterol of the experimental group was significantly different from that of the control group(P < 0.05).The experimental group was higher than the control group,but there was no statistical significance in age,gender,eye difference,intraocular pressure and triglyceride between the two groups(P > 0.05).The intraocular pressure in fibroproliferative group was higher than that in neovascularization group,with statistical significance(P < 0.05),but there were no statistical significance in age,gender,diabetes course,glycosylated hemoglobin,triglyceride,creatinine,insulin injection or not,and total cholesterol between the two groups(P > 0.05).2.Comparison of MCP-1,IL-8 and VEGF in aqueousThe concentration of IL-8 and VEGF in aqueous between three groups was statistically significant(P < 0.05),but the concentration of MCP-1 in aqueous humor between three groups was not statistically significant(P > 0.05).The expression of IL-8 in aqueous humor in fibroproliferation group was higher than that in angiogenesis group,with statistical difference(P < 0.05),while there was no statistical significance in the expression of MCP-1 and VEGF in aqueous humor between the angiogenesis group and fibrogenesis group(P > 0.05).There was no correlation between IL-8,MCP-1 and VEGF in aqueous humor(P > 0.05).3.Comparison with MCP-1,IL-8 and VEGF in vitreousThe differences of MCP-1,IL-8 and VEGF in vitreous among three groups were statistically significant(P < 0.05).Compared with the two groups,the concentrations of MCP-1 and IL-8 in the neovascularization group were significantly higher than those in the neovascularization group,with statistical significance(P <0.05),but the levels of VEGF in the neovascularization group and the fibroproliferation group were not statistically significant(P > 0.05).4.Correlation analysis of cytokines in vitreous fluidsIn vitreous,IL-8 was positively correlated with MCP-1 level,VEGF was positively correlated with IL-8 level,and VEGF was not correlated with MCP-1 level.There was a statistically significant positive correlation between the level of MCP-1and intraocular pressure in vitreous(r=0.528,P<0.05).5.Comparison and correlation analysis of IL-8,MCP-1 and VEGF in aqueous and vitreousThe expressions of IL-8 and VEGF in vitreous were significantly higher than those in aqueous(P < 0.05).The expressions of IL-8、VEGF in aqueous humor were significantly correlated with those in vitreous(r=0.724,P < 0.05 、 r=0.388,P <0.05).The expressions of MCP-1 in aqueous humor were not correlated with those in vitreous(r=0.482,P>0.05).Conclusion:1.Inflammatory factors and vascular endothelial genic factors in PDR are involved in the occurrence of the disease.However,in patients with PDR whose fundus phenotype is mainly fibroproliferative membrane,cytokines in aqueous humor and vitreous fluid are mainly involved in the occurrence and development of PDR with the increase of inflammatory related factors as the main trend.2.The concentration of cytokines in vitreous was significantly higher than that in aqueous,and there was a significant correlation between IL-8、VEGF in aqueous humor and vitreous body fluid.Extraction of IL-8、VEGF in aqueous may help to understand the pathogenesis and development of PDR.3.The intraocular pressure in PDR was correlated with the severity of intraocular inflammatory response.