Dynamic Changes of Aqueous Matrix Metalloproteinases and Imaging Correlation in Retinal Vein Occlusion Following Ranibizumab Therapy

Purpose: To investigate changes in aqueous humour matrix metalloproteinases (MMPs) after intravitreal ranibizumab (IVR) therapy, and their correlations with imaging parameters in retinal vein occlusion (RVO). Methods: Aqueous humour samples from 28 RVO patients were collected at baseline, 1 and 2 months after IVR therapy. MMP-1, -2, -3, -7, -8, -9, -10, TIMP-1, and VEGF-A levels were measured using Luminex × MAP ® . Participants were categorized as Responders or Non-responders based on ≥ 30% central retinal thickness (CRT) reduction at month 2. MMPs and TIMP-1 changes were analyzed. Correlations between baseline MMP-1, MMP-2, TIMP-1, and retinal structural and microvascular parameters were assessed. Multivariate regression analyzed associations with treatment response. Results: Intraocular MMP-1, MMP-2, and TIMP-1 levels significantly decreased in responders but not in non-responders. Baseline MMP-1, MMP-2, and TIMP-1 were positively correlated with CRT, IS-OS and ELM disruption, DRIL, and SRD height (all P < 0.05). Negative correlations were observed between MMP-1 (r=-0.520, P =006), TIMP-1 (r=-0.416, P =0.039) and FAZ size. Higher baseline MMP-1 ( P =0.024) and lower TIMP-1 ( P =0.034) levels were associated with greater CRT reduction. Conclusion: Aqueous MMP-1, MMP-2, and TIMP-1 are associated with in macular edema, retinal damage, and microvascular changes in RVO. Baseline MMP-1 and TIMP-1 may serve as potential biomarkers for predicting short-term therapeutic response.