Pro-permeability Factors in Diabetic Macular Edema; the Diabetic Macular Edema Treated with Ozurdex Trial

• Published in: American journal of ophthalmology 2016-08, Vol.168, p.13-23
• Main Authors: Campochiaro, Peter A, Hafiz, Gulnar, Mir, Tahreem A, Scott, Adrienne W, Zimmer-Galler, Ingrid, Shah, Syed M, Wenick, Adam S, Brady, Christopher J, Han, Ian, He, Lingmin, Channa, Roomasa, Poon, David, Meyerle, Catherine, Aronow, Mary Beth, Sodhi, Akrit, Handa, James T, Kherani, Saleema, Han, Yong, Sophie, Raafay, Wang, Guohua, Qian, Jiang
• Format: Article
• Language: English
• Subjects: Aged; Angiogenesis; Angiogenesis Inhibitors - therapeutic use; Aqueous Humor - metabolism; Bevacizumab; Cross-Over Studies; Cytokines; Delayed-Action Preparations - therapeutic use; Dexamethasone - therapeutic use; Diabetes; Diabetic retinopathy; Diabetic Retinopathy - drug therapy; Diabetic Retinopathy - metabolism; Diabetic Retinopathy - pathology; Drug Implants; Edema; Eye Proteins - metabolism; Female; Glucocorticoids - therapeutic use; Humans; Hypoxia; Intercellular Signaling Peptides and Proteins - metabolism; Macular Edema - drug therapy; Macular Edema - metabolism; Macular Edema - pathology; Male; Middle Aged; Ophthalmology; Patients; Permeability; Pharmaceutical industry; Prospective Studies; Proteins; Rodents; Vascular endothelial growth factor; Visual Acuity
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2016.04.017

Abstract Purpose The D iabetic M acular E dema Treated with O zurdex (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. Design Prospective, randomized cross-over clinical trial Methods Twenty DME patients randomized to dexamethasone implant or VEGF-neutralizing protein had aqueous taps and spectral domain-optical coherence tomography (SD-OCT) at baseline and every 4 weeks for 28 weeks. Aqueous levels of 55 vasoactive proteins were measured with protein array. Cross-over at week 16 provided changes in protein levels after each intervention in all 20 patients. Results After dexamethasone implant there was significant correlation between changes in levels of 13 vasoactive proteins with changes in EFT, including three known PPFs, angiopoietin-2 (r=0.40, p=0.001), hepatocyte growth factor (HGF, r=0.31, p=0.02), and endocrine gland-VEGF (EG-VEGF, r=0.43, p