Aqueous Humour Cytokine Levels in Fuchs Endothelial Corneal Dystrophy

Theme: Cornea, external disease & refractive surgery
What: Posters
Part of: Poster Presentations / Présentations d'affiches | Break in the Exhibition Hall / Pause dans la salle d’exposition
When: 6/1/2024, 10:30 AM - 11:15 AM
Where: Exhibition Hall | Salle d'exposition

Abstract

Purpose: Fuchs endothelial corneal dystrophy (FECD) is characterized by progressive corneal endothelium dysfunction and apoptosis of corneal endothelial cells and development of guttae. Although the pathogenesis of FECD is incompletely understood, genetic, endocrine, and environmental factors have been implicated in disease progression. Few reports have assessed the intraocular cytokine levels of patients afflicted with this disease. This study aims to characterize the expression of pro- and anti-inflammatory factors in the aqueous humour of patients with FECD.

Study design: Prospective cohort study

Methods: Patients with a diagnosis of either FECD with or without cataract, or cataract only requiring surgical intervention were prospectively enrolled in this study. An anterior chamber paracentesis was performed before surgery and aqueous humour was collected for analysis. The primary outcome of this study is aqueous cytokine expression of interleukin (IL)-1α, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, IL-15, transforming growth factor (TGF)-α, TGF-β-1/-2/-3, FMS-related tyrosine kinase 3 ligand (Flt3L), vascular endothelial growth factor A (VEGF-A), Tumor necrosis factor (TNF)- α, TNF-β, and granulocyte-colony stimulating factor (GCSF) which was measured using multiplex bead array assays. Additionally, we recorded relevant demographic and clinical data for each included participant.

Results: A total of 50 eyes from 25 patients (15 women; 10 men) with FECD were included in this study. Thirteen healthy eyes undergoing cataract extraction with intraocular lens implant (CE IOL) served as the control group. The average age of the included patients with FECD was 70. Two patients were smokers and 14 were non-smokers. 64% (32/50) of eyes underwent a surgical intervention. Of these, 84% (27/32) were FECD phakic eyes that underwent combined Descemet's membrane endothelial keratoplasty (DMEK) and CE IOL and 16% (5/32) were pseudophakic eyes that underwent DMEK only. Aqueous cytokine expression analysis demonstrated increased expression of TGF-β2 in phakic FECD patients undergoing DMEK and CE IOL when compared to the cataract control group (p = 0.0040) and pseudophakic FECD patients undergoing DMEK only (p = 0.0405). There is increased expression of TGF-α (p = 0.0273), IL-2 (p = 0.0221) and IL-22 (p = 0.0251) in the cataract control group when compared to the phakic FECD patients. Pseudophakic FECD patients undergoing DMEK had higher expression of GCSF (p = 0.0314), FLT3L (p = 0.0208) and IL-8 (p = 0.0425) when compared to phakic FECD patients undergoing DMEK and CE IOL. There were no statistically significant differences in expression of the remaining cytokines in all three patient groups.

Conclusions: There are distinct inflammatory signatures in FECD phakic patients and pseudophakic FECD patients. Future studies are needed to investigate their contribution to FECD pathogenesis.  

Presenter(s)

Presenting Author: Sonia Anchouche

Additional Author(s):

Manokamna Agarwal, Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada

Narisa Dhupar, Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada

Lina Chen, Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada

Stephan Ong Tone, Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Canada

---