Discrimination of anti-VEGF drug ineffective cases and steroid treatment ineffective cases of diabetic macular edema and elucidation of pathophysiology

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K18356
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56060:Ophthalmology-related
• Research Institution: Jichi Medical University
• Principal Investigator: Sakamoto Shinichi 自治医科大学, 医学部, 助教 (30721071)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: 糖尿病黄斑浮腫 / サイトカイン / 眼房水 / ステロイド / 抗VEGF薬

Outline of Final Research Achievements

Diabetic macular edema (DME) is a disease that is associated with diabetic retinopathy even when it is relatively mild, resulting in decreased visual acuity. Inflammation and vascular endothelial growth factor (VEGF) are involved, and topical steroid administration or intravitreal injection of anti-VEGF drugs is performed. However, there are many cases in which only one treatment is effective, and it is not possible to distinguish between them before treatment. In this study, we measured the concentrations of various cytokines in the aqueous humor of the eye before DME treatment and investigated the relationship with treatment responsiveness. As a result, when GM-CSF was high and CXCL1 was low in the aqueous humor of the eye before treatment, it was shown that steroid treatment may be more effective than anti-VEGF drugs.

Free Research Field

網膜硝子体

Academic Significance and Societal Importance of the Research Achievements

糖尿病網膜症は本邦の後天性失明原因第一位である。糖尿病黄斑浮腫(DME)は糖尿病網膜症が比較的軽い時期にも合併し視力低下を来す。炎症及び血管内皮増殖因子(VEGF)が関与し、ステロイドあるいは抗VEGF薬の硝子体内注射で治療するが、そのどちらが有効か治療前に判別困難であった。本研究の結果、DME治療前に眼房水を採取してサイトカイン濃度測定を行うことで、眼房水中のGM-CSFが高く、CXCL1が低いとステロイド治療方が抗VEGF薬と比較して治療効果が高いと考えられ、有効な治療選択の一助になると考えられる。