Aqueous humour concentrations of TGF-β, PLGF and FGF-1 and total retinal blood flow in patients with early non-proliferative diabetic retinopathy

TitleAqueous humour concentrations of TGF-β, PLGF and FGF-1 and total retinal blood flow in patients with early non-proliferative diabetic retinopathy
Publication TypeJournal Article
Year of Publication2017
AuthorsKhuu, L. - A., F. Tayyari, J. Sivak, J. Flanagan, S. Singer, M. Brent, D. Huang, O. Tan, and C. Hudson
JournalActa Ophthalmologica
Keywordsaged, angiogenesis, aqueous humor, aqueous humour cytokines, Article, biological marker, Biomarkers, blood flow, cataract extraction, clinical article, controlled study, Diabetes Mellitus, diabetic retinopathy, diagnostic imaging, female, fibroblast growth factor, fibroblast growth factor 1, hemoglobin A1c, human, Humans, male, metabolism, non insulin dependent diabetes mellitus, non-proliferative diabetic retinopathy, nonproliferative diabetic retinopathy, Optical Coherence, Optical coherence tomography, optical coherence tomography device, pathophysiology, PGF protein, physiology, Placenta Growth Factor, placental growth factor, procedures, Regional Blood Flow, retina blood flow, retina blood vessel, retinal blood flow, Retinal Vessels, Tomography, transforming growth factor beta, transforming growth factor beta1, transforming growth factor beta2, Type 2, type 2 diabetes mellitus, vasoregulatory

Purpose: To correlate angiogenic cytokines in the aqueous humour with total retinal blood flow in subjects with type 2 diabetes with non-proliferative diabetic retinopathy (NPDR). Methods: A total of 17 controls and 16 NPDR patients were recruited into the study. Aqueous humour was collected at the start of cataract surgery to assess the concentration of 14 angiogenic cytokines. Aqueous humour was analysed using the suspension array method. Six images were acquired to assess total retinal blood flow (TRBF) using the prototype RTVue™ Doppler Fourier domain optical coherence tomography (Doppler FD-OCT) (Optovue, Inc., Fremont, CA) using a double circular scan protocol, 1 month postsurgery. At the same visit, forearm blood was collected to determine glycosylated haemoglobin (A1c). Results: Transforming growth factor beta (TGF-β1, TGF-β2) and PLGF were increased while FGF-1 was reduced in NPDR compared to controls (Bonferroni corrected, p < 0.003 for all). Total retinal blood flow (TRBF) was significantly reduced in the NPDR group compared to controls (33.1 ± 9.9 versus 43.3 ± 5.3 μl/min, p = 0.002). Aqueous FGF-1 significantly correlated with TRBF in the NPDR group (r = 0.71, p = 0.01; r2 = 0.51). In a multiple regression analysis, A1c was found to be a significant predictor of aqueous TGF-β1 and FGF-1 (p = 0.018 and p = 0.020, respectively). Conclusion: Aqueous angiogenic cytokines (TGF-β1, TGF-β2 and PLGF) were elevated in conjunction with a reduction in TRBF in patients with NPDR compared to controls. Non-invasive measurement of TRBF may be useful for predicting aqueous FGF-1 levels and severity of vasculopathy in DR. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd