Pathogenesis of Macular Edema With Branch Retinal Vein Occlusion and Intraocular Levels of Vascular Endothelial Growth Factor and Interleukin-6

Purpose To determine whether correlations between vascular endothelial growth factor (VEGF) or interleukin-6 (IL-6) contribute to the pathogenesis of macular edema in eyes of patients with branch retinal vein occlusion (BRVO). Design Retrospective case-control study. Methods Nineteen patients with macular edema with BRVO and seven patients with non-ischemic ocular disease (control group) were studied. The degree of retinal ischemia was evaluated in terms of the area of capillary non-perfusion, and the severity of macular edema was examined by optical coherence tomography. Aqueous humor samples were obtained at the time of combined vitrectomy and cataract surgery, and VEGF and IL-6 levels in aqueous humor and plasma were determined by enzyme-linked immunosorbent assay. Results Aqueous levels of VEGF (351 ± 273 pg/ml) and IL-6 (7.10 ± 6.51 pg/ml) were significantly elevated in patients with BRVO compared with the control patients (119 ± 38.7 pg/ml and 2.27 ± 1.11 pg/ml, respectively) ( P = .0017 and P = .0052, respectively). Aqueous level of VEGF was significantly correlated with that of IL-6 ( P = .0396), and aqueous levels of VEGF and IL-6 were correlated with the size of the BRVO non-perfused area ( P P = .0331, respectively). Aqueous level of VEGF was correlated with the severity of macular edema ( P = .0306). Conclusions VEGF and IL-6 may be involved in the pathogenesis of macular edema with BRVO. The increase in these cytokines might be used as a unique index of BRVO, through which we can determine the severity of the ischemic condition as being in a quiescent state or an exacerbation of macular edema.