Aqueous Humor Cytokine Profiles of Pachychoroid Spectrum Diseases

Abstract

Abstract Objectives To investigate cytokine profiles in the aqueous humor (AH) of patients with central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV), and polypoidal choroidal vasculopathy (PCV). Methods The prospective study included a total of 172 eyes. AH samples were collected from 65 eyes with CSC, 24 with PNV, and 43 with PCV before intravitreal anti-vascular endothelial growth factor (VEGF) injection and cataract surgery in 40 control eyes. Multiplex bead assay was used for analysis of cytokines, including VEGF, interleukin-6 (IL-6), IL-8, IL-10, interferon-inducible protein 10 (IP-10), macrophage chemoattractant protein 1 (MCP-1). Differences in cytokine levels between groups were assessed. Results No differences were noted in IL-6 (P = 0.122) and MCP-1 (P = 0.054) levels among the CSC, PNV, PCV, and controls. VEGF levels in CSC, PNV, and PCV were significantly higher than in controls (all P < 0.05). In CSC or PNV, no other inflammatory cytokines were upregulated except for VEGF compared to controls. In PCV, VEGF, IL-10, and IP-10 levels were significantly higher than those in controls. In addition, we compared the cytokines levels between two pigment epithelial detachment (PED) types in CSC patients. VEGF levels were significantly higher in eyes with flat irregular PED (FIPED) than in focal PED (P = 0.027). Conclusions In CSC and PNV, VEGF levels were elevated without the elevation of other inflammatory cytokines, indicating that inflammation was not the dominant factor on CSC and PNV diseases. PCV had significantly distinct cytokine profiles in the AH compared with controls. Elevated angiogenic and inflammatory cytokines, including VEGF, IL-10, and IP-10, may contribute to the pathogenesis of PCV. In addition, higher VEGF levels in CSC patients with FIPED verified that VEGF contributed more to the pathogenesis of FIPED compared with focal PED.