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. 2014:2014:502174.
doi: 10.1155/2014/502174. Epub 2014 Jul 10.

Aqueous interleukin-6 levels are superior to vascular endothelial growth factor in predicting therapeutic response to bevacizumab in age-related macular degeneration

Kakarla V Chalam  1 , Sandeep Grover  1 , Kumar Sambhav  1 , Sankarathi Balaiya  1 , Ravi K Murthy  1
Affiliations

Aqueous interleukin-6 levels are superior to vascular endothelial growth factor in predicting therapeutic response to bevacizumab in age-related macular degeneration

Kakarla V Chalam et al. J Ophthalmol. 2014.

Abstract

Objective. To prospectively evaluate the effect of intravitreal bevacizumab on aqueous levels of interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) in patients with exudative age-related macular degeneration (AMD) and correlate clinical outcomes with cytokine levels. Methods. 30 eyes of 30 patients with exudative AMD underwent intravitreal injection of bevacizumab three times at monthly intervals. The aqueous samples prior to the 1st injection (baseline) and 3rd injection were analyzed for VEGF and IL-6 levels. Subjects were subgrouped based upon change in the central subfield (CSF) macular thickness on SD-OCT at 8 weeks. Group 1 included patients (n = 14) with a decrease in CSF thickness greater than 10% from the baseline (improved group). Group 2 included patients (n = 16) who had a decrease in CSF thickness 10% or less (treatment-resistant). Results. In subgroup analysis, in both groups 1 and 2 patients, compared to aqueous VEGF, aqueous IL-6 levels showed a better correlation with CSF thickness on SD-OCT (r = 0.72 and 0.71, resp.). Conclusions. Aqueous IL-6 may be an important marker of treatment response or resistance in wet macular degeneration. Future therapeutic strategies may include targeted treatment against both VEGF and IL-6, in patients who do not respond to anti-VEGF treatment alone.

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Figures

Figure 1
Figure 1
Column chart showing the change in mean aqueous VEGF levels (a) and change in mean aqueous IL-6 levels (b) in the study patients. The error bar represents standard deviation.
Figure 2
Figure 2
Box plot diagram showing the change in mean aqueous VEGF levels (a) and change in mean aqueous IL-6 levels (b) in patients in group 1. The error bar represents standard deviation.
Figure 3
Figure 3
Box plot diagram showing the change in mean aqueous VEGF levels (a) and change in mean aqueous IL-6 levels (b) in patients in group 2. The error bar represents standard deviation.
Figure 4
Figure 4
Correlation plot showing correlation between aqueous VEGF (a) and aqueous IL-6 levels (b) with central subfield thickness on Spectralis OCT in patients in group 1.
Figure 5
Figure 5
Correlation plot showing correlation between aqueous VEGF (a) and aqueous IL-6 levels (b) with central subfield thickness on Spectralis OCT in patients in group 2.
See this image and copyright information in PMC

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