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. 2022 Mar;260(3):747-758.
doi: 10.1007/s00417-021-05445-0. Epub 2021 Oct 29.

Cytokine profiles of macular neovascularization in the elderly based on a classification from a pachychoroid/drusen perspective

Satoru Inoda  1 , Hidenori Takahashi  2   3 , Yuji Inoue  1 , Xue Tan  4 , Hironobu Tampo  1 , Yusuke Arai  1 , Yasuo Yanagi  1   5 , Hidetoshi Kawashima  1
Affiliations

Cytokine profiles of macular neovascularization in the elderly based on a classification from a pachychoroid/drusen perspective

Satoru Inoda et al. Graefes Arch Clin Exp Ophthalmol. 2022 Mar.

Abstract

Purpose: To classify macular neovascularization (MNV) based on pachychoroid and drusen features and to examine the aqueous humor cytokine signatures of each group.

Methods: In total, 106 consecutive eyes with treatment-naïve MNV and 104 control eyes were examined. The aqueous humor concentrations of 15 cytokines were compared among the MNV groups classified based on the presence of drusen and/or pachychoroid features. Multidimensional scaling analysis was used to visualize the similarity level of the MNV subtypes according to their cytokine profiles.

Results: Thirty-one, 18, 43, and 10 eyes were classified into the pachychoroid-associated, drusen-associated, pachychoroid/drusen-associated, and non-drusen/non-pachychoroid MNV groups, respectively. Compared with the control group, cytokines were differently upregulated among the MNV groups. CRP and CXCL12 were significantly upregulated in all MNV groups, whereas CXCL13 and IL-8 were significantly upregulated in three MNV groups, excluding the non-pachychoroid/non-drusen-associated MNV group. Ang-2 was significantly upregulated in three MNV groups except the drusen-associated MNV group. PlGF was significantly upregulated in the pachychoroid-associated and drusen-associated MNV groups. CCL-2 was significantly upregulated in the pachychoroid-associated and pachychoroid/drusen-associated MNV groups. VEGF was downregulated in the pachychoroid-associated and drusen-associated MNV groups, respectively. Multidimensional scaling analysis showed a distinct cytokine profile for each MNV group.

Conclusion: All MNV groups showed distinct cytokine profiles. Eyes with "neovascular age-related macular degeneration with drusen and concomitant pachychoroid" may share a similar etiology to those with "pachychoroid neovasculopathy" and "choroidal neovascularization with drusen," but have a distinct etiology to those without these. These findings suggest the importance of evaluating drusen and the choroid during the diagnosis of neovascular age-related macular degeneration.

Keywords: Age-related macular degeneration; Choroidal neovascularization; Drusen; Inflammatory cytokines; Pachychoroid.

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