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Measuring biomarkers may Identify patients at risk of retinal vascular progression after cataract surgery

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Investigators wanted to determine why patients who have retinal diseases such as diabetic retinopathy (DR) or age-related macular degeneration (AMD) can undergo cataract surgeries without experiencing a worsening of their retinal disease, while some patients do.

(Image Credit: AdobeStock/Alessandro Grandini)

(Image Credit: AdobeStock/Alessandro Grandini)

Pre-existing levels of vascular endothelial growth factor (VEGF) may predispose certain patients who undergo cataract surgery to develop a retinal pathology postoperatively, reported Naren Shetty, MS, who described the study at the American Society of Cataract and Refractive Surgery annual meeting in Boston.1 Shetty is from Narayana Nethralaya Eye Hospital, Bangalore, India.

He and his colleagues pointed out that while patients who have retinal diseases such as diabetic retinopathy (DR) or age-related macular degeneration (AMD) can undergo cataract surgeries without experiencing a worsening of their retinal disease, some patients do experience worsening. The investigators wanted to determine why that occurs.

To do so, they collected samples of aqueous humor from patients who were undergoing cataract surgeries. Optical coherence tomography was performed preoperatively in all patients and patients found to have non-proliferative and proliferative DR were not included.

The investigators recorded the patients’ diabetic, DR, and hypertension status and followed the patients for 6 to 12 months. They reported conducting testing of a panel of 8 markers on each aqueous humor sample.

In 42 eyes tested, the retinal pathology increased in 5 eyes; Shetty described this as progression to moderate or severe non-proliferative DR and development of diabetic macular edema (DME) compared to the eyes that remained stable.

He and his colleagues reported, “The levels of VEGF in the group with progressive retinal pathology were significantly higher (p<0.05) compared to the group without progressive retinal pathology at the time of cataract surgery.”

Other markers such as interleukin (IL)-6, -10, -1b, and -17A; tumor necrosis factor-a; matrix metalloproteinase 9; and soluble intercellular adhesion molecule-1 did not show significant differences.

The investigators believe that the levels of VEGF present at the time of cataract surgery may result in development of detrimental retinal pathology postoperatively. “Using biomarker testing to stratify patients to enable close monitoring or prophylactic care may help reduce the risk of DME postoperatively,” they concluded.

  1. Conference Abstract or Poster
    Shetty N, Shetty R, Khamar P,et al. Novel biomarker levels to identify risk of retinal vascular progression post cataract surgery. Paper presented at: American Society of Cataract and Refractive Surgery 2024 annual meeting; April 5-8, 2024; Boston, Massachusetts, USA. Session: SPS-202 Retina
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