Journal article
Pro-permeability Factors in Diabetic Macular Edema; the Diabetic Macular Edema Treated With Ozurdex Trial
American journal of ophthalmology, Vol.168, pp.13-23
08/2016
DOI: 10.1016/j.ajo.2016.04.017
PMCID: PMC5482180
PMID: 27130369
Abstract
The Diabetic Macular Edema Treated with Ozurdex (DMEO) Trial measured aqueous pro-permeability factors (PPFs) in diabetic macular edema (DME) patients before and after injection of dexamethasone implant or vascular endothelial growth factor (VEGF)-neutralizing protein and correlated changes in levels with changes in excess foveal thickness (EFT) to identify potential PPFs contributing to DME. Prospective, randomized crossover clinical trial. Twenty DME patients randomized to dexamethasone implant or VEGF-neutralizing protein had aqueous taps and spectral-domain optical coherence tomography (SDOCT) at baseline and every 4 weeks for 28 weeks. Aqueous levels of 55 vasoactive proteins were measured with protein array. Crossover at week 16 provided changes in protein levels after each intervention in all 20 patients. After dexamethasone implant there was significant correlation between changes in levels of 13 vasoactive proteins with changes in EFT, including 3 known PPFs: angiopoietin-2 (r = 0.40, P = .001), hepatocyte growth factor (HGF; r = 0.31, P = .02), and endocrine gland-VEGF (EG-VEGF, r = 0.43, P < .001). Reduction of prolactin, insulin-like growth factor binding protein-3, and matrix metalloproteinase-9 correlated with edema reduction after injection of a VEGF-neutralizing protein as well as dexamethasone implant, suggesting their modulation is likely secondary to changes in edema rather than causative. Correlation of edema reduction with reduction in the PPFs angiopoietin-2, HGF, and EG-VEGF provides potential insight into the multifactorial molecular mechanism by which dexamethasone implants reduce edema and suggest that additional study is needed to investigate the contributions of these 3 factors to chronic DME.
Details
- Title: Subtitle
- Pro-permeability Factors in Diabetic Macular Edema; the Diabetic Macular Edema Treated With Ozurdex Trial
- Creators
- Peter A Campochiaro - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: pcampo@jhmi.eduGulnar Hafiz - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandTahreem A Mir - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandAdrienne W Scott - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandIngrid Zimmer-Galler - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandSyed M Shah - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandAdam S Wenick - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandChristopher J Brady - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandIan Han - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandLingmin He - Johns Hopkins University School of MedicineRoomasa Channa - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandDavid Poon - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandCatherine Meyerle - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandMary Beth Aronow - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandAkrit Sodhi - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandJames T Handa - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandSaleema Kherani - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandYong Han - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandRaafay Sophie - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandGuohua Wang - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MarylandJiang Qian - Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Resource Type
- Journal article
- Publication Details
- American journal of ophthalmology, Vol.168, pp.13-23
- DOI
- 10.1016/j.ajo.2016.04.017
- PMID
- 27130369
- PMCID
- PMC5482180
- NLM abbreviation
- Am J Ophthalmol
- ISSN
- 0002-9394
- eISSN
- 1879-1891
- Publisher
- United States
- Grant note
- P30 EY001765 / NEI NIH HHS KL2 TR001077 / NCATS NIH HHS
- Language
- English
- Date published
- 08/2016
- Academic Unit
- Ophthalmology and Visual Sciences
- Record Identifier
- 9983979954802771
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