Analyzing cytokines as biomarkers to evaluate severity of glaucoma

AIM： To analyze cytokines as biomarkers for evaluation of severity of glaucoma. METHODS： This was a prospective case-control study including 29 eyes with glaucoma. Besides, 28 eyes with senile cataract were used as control. Patients were classified into four groups： acute angle closure glaucoma （AACG）, chronic angle closure glaucoma （CACG）, primary open angle glaucoma （POAG） and senile cataract. Undiluted vitreous samples were collected, then vitreous concentrations of 9 types of cytokines were determined by cytometric bead assay system： y-interferon （IFNg）, interleukin （IL-10, IL-2, IL-4, IL-5, interferon-y-inducible protein （IP）-10, monocyte chemoattractant protein （MCP）-I, tumor necrosis factor （TNF） -Q, and vascular endothelial growth factor （VEGF）. We also recorded the intraocular pressure （lOP） of patients in each group and Pearson correlated analysis was performed to analysis the correlation between each type of cytokine with IOR RESULTS： Vitreous levels of IL-2, iL-5, MCP-1, TNF-a and IP-10 were significantly higher （P〈0.05） in AACG group. Patients with AACG, CACG and POAG have higher lOP than senile cataract, but we didn＇t find any significant correlation between lOP with any type of the cytokines. CONCLUSION： Inflammation and immune reaction have a strong link with the pathology of glaucoma especially AACG, Some cytokines may act as biomarkers to evaluate the severity of glaucoma, Anti-inflammatory treatments and controlling of lOP are necessary for the therapy of glaucoma.

Comparison of the efficacy of anti-VEGF monotherapy versus PDT and intravitreal anti-VEGF combination treatment in AMD： a Meta-analysis and systematic review

AIM：To compare the effect of anti-vascular endothelial growth factor（VEGF） monotherapy versus photodynamic therapy（PDT） and anti-VEGF combination treatment in age-related macular degeneration（AMD）.METHODS：A computerized online search was performed using PubMed,Web of Science and the Cochrane Library.Studies that compared anti-VEGF monotherapy with PDT and anti-VEGF combination treatment of AMD and were designed as randomized controlled trials were included.The means and standard deviations of the best-corrected visual acuity（BCVA）,central retinal thickness（CRT）,number of treatments and proportions of patients who gained BCVA ≥15,10,5,or 0 letters at 12^（th） month were extracted.A systematic review and Meta-analysis of the comparison of the two approaches was conducted using Review Manager 5.2.Subgroup.A sensitivity analysis was also performed.RESULTS：Eight studies were included.When the subgroup and sensitivity analysis was conducted,the results indicated that in the findings that included the monotherapy group and PDT（standard fluence,SF）group of Kaiser＇s study,the patients in the monotherapy group had a better BCVA compared with the combination group at 12^（th） month in the PDT（SF） subgroup[weighted mean difference（WMD）：3.54;95% Cl：0.36 to 6.73;P=0.03],and there were more patients who gained ≥15 letters of BCVA in the monotherapy group compared with the combination group in the total result[odds ratio（OR）：1.41;95% Cl：1.02 to 1.95;P=0.04].The same conclusion was obtained in the total result that included the monotherapy group and PDT（reduced fluence,RF）group of Kaiser＇s study（OR：1.56;95% CI：1.13 to 2.15;P=0.007）.However,there were no significant differences in the other indexes between the two therapies.CONCLUSION：We found that anti-VEGF monotherapy is more effective on the recovery of visual acuity than combination therapy and more researches with lager sample size should be performed to study on the effect of the two therapy approaches on CRT and number of injections.