Intraocular Concentrations of Cytokines and Chemokines in Rhegmatogenous Retinal Detachment and the Effect of Intravitreal Triamcinolone Acetonide

PURPOSE: To investigate the role of intravitreal injection of triamcinolone acetonide (IVTA) in preventing photoreceptor apoptosis in eyes with rhegmatogenous retinal detachment (RRD) by measuring cytokine levels in the aqueous humor before and after IVTA. DESIGN: Prospective, nonrandomized, interventional case series. METHODS: SETTING: Institutional. PATIENTS: Nineteen eyes of 19 consecutive patients with RRD. INTERVENTION: All 19 eyes underwent IVTA 1 day before 25-gauge vitrectomy. Seventeen eyes free of retinal vascular disease served as controls. MAIN OUTCOME MEASURE: Both baseline and 1 day post-IVTA measurements were made of the relative concentrations of 15 soluble factors (3 cytokines, 7 chemokines, and 5 growth factors). The associations with clinical findings, including macular status, were then analyzed. RESULTS: Elevated monocyte chemotactic protein 1 (MCP-1), macrophage inflammatory protein 1 beta (MIP-1 beta), and interferon gamma-induced protein 10 (IP-10) in eyes with RRD were significantly reduced after IVTA. MCP-1 levels were significantly correlated with MIP-1 beta and IP-10 before and after IVTA. The decreases in MCP-1, MIP-1 beta, and IP-10 were also closely correlated to each other. Both before and after IVTA, MCP-1 was higher in eyes with macula-off RRD than in eyes with macula-on RRD. CONCLUSIONS: IVTA suppressed elevated levels of intraocular MCP-1, MIP-1 beta, and IP-10 in eyes with RRD. The decrease in the aqueous levels of each of these factors was significantly correlated with the others. In addition to MCP-1, MIP-1 beta and IP-10 might potentially be additional target molecules for RRD therapy. ((c) 2013 by Elsevier Inc. All rights reserved.)