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, 13 (9), e0203408

Aqueous Humor Cytokine Levels in Patients With Diabetic Macular Edema Refractory to anti-VEGF Treatment


Aqueous Humor Cytokine Levels in Patients With Diabetic Macular Edema Refractory to anti-VEGF Treatment

Jin-Woo Kwon et al. PLoS One.

Erratum in


Purpose: To determine aqueous cytokines association with response to intravitreal bevacizumab (IVB) injection in diabetic macular edema (DME).

Method: We compared the concentrations of IL (interleukin)-1β, IL-2, IL-8, IL-10, IL-17, placental growth factor (PlGF), and vascular endothelial growth factor (VEGF) in the aqueous humor of 64 naïve DME patients with those of 13 cataract patients. Factors associated with central subfield thickness (CST) in DME patients were identified. DME patients were then subgrouped in terms of responsiveness to three IVB injections; cytokine concentrations were compared, and factors associated with responsiveness were identified.

Results: Levels of IL-2, IL-8, PlGF, and VEGF were significantly elevated in DME patients (p = 0.007, p < 0.001, p < 0.001, and p = 0.004 respectively). Regression analysis showed that the preoperative CST was associated with the preoperative best-corrected visual acuity and the aqueous IL-10 level (p < 0.001, p = 0.006, respectively). Of the 64 DME patients, 28 (43.75%) exhibited either CST < 300 μm or reduction in CST ≥ 50 μm after three consecutive IVB injections. On sub-group analysis, the mean IL-8 concentration was higher in the refractory group than in the responsive group, and multivariate logistic regression analysis showed that the IL-8 was the only factor associated with responsiveness (OR = 0.95, p = 0.017).

Conclusions: The IL-8 concentration in the aqueous humor was associated with responsiveness to IVB in DME patients.

Conflict of interest statement

The authors have declared that no competing interests exist.


Fig 1
Fig 1. Box-and-whisker plots for central subfield thickness (CST), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) changes in patients receiving dexamethasone implants due to poor responsiveness to 3 months of intravitreal bevacizumab (IVB) injections.
The circles represent outliers. (A) CST was significantly reduced both after IVB injection and placement of dexamethasone implants. (B) BCVA did not improve significantly after IVB injection, but did upon dexamethasone treatment. (C) The baseline IOP was 15.52 ± 3.23 mmHg, and increased significantly to 16.61 ± 2.21 mmHg after placement of dexamethasone implants.

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Grant support

This work was supported by the National Research Foundation of Korea Grant funded by the Korean government (MSIP), No.NRF- 2016R1D1A1B03932606 ( to Donghyun Jee. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.