Abstract
Aim
To determine whether the functional −174 G/C interleukin-6 gene polymorphism is a risk factor for the development of cystoid macular oedema (CMO) following routine uncomplicated phacoemulsification surgery in patients with no established risk factors.
Methods
A total of 40 patients who underwent routine phacoemulsification surgery as part of a randomised controlled trial comparing the use of postoperative steroid drops against a single sub-tenon injection of triamcinolone were genotyped for the IL-6 −174G/C polymorphism. All patients underwent fluorescein angiography at 30 days and anterior chamber flare measurements pre-operatively and at day 1, 7, and 30.
Results
Angiographic CMO developed in 14 patients of the 40 studied. 9 out of the 14 patients carried the GG genotype (Fisher's exact test P=0.05, Hazard ratio for GG genotype; 4.05 (1.02–16.00)). There was no difference in flare measurements between the GG and Non-GG (GC/CC) group. The two groups were otherwise well matched in terms of age, sex, phacoemulsification energy used intraoperatively, and proportion of patients receiving postoperative triamcinolone or steroid drops.
Conclusion
The −174G/C interleukin-6 promoter gene variant appears to modulate the response to phacoemulsification surgery and to influence the development of postoperative CMO. These data suggest a genetic predisposition to this complication.
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References
Drolsum L, Haaskjold E . Causes of decreased visual acuity after cataract extraction. J Cataract Refract Surg 1995; 21: 59–63.
Irvine SR . A newly defined vitreous syndrome following cataract surgery, interpreted according to recent concepts of the structure of the vitreous. Am J Ophthalmol 1953; 36: 599–619.
Ursell PG, Spalton DJ, Whitcup SM, Nussenblatt RB . Cystoid macular edema after phacoemulsification: relationship to blood–aqueous barrier damage and visual acuity. J Cataract Refract Surg 1999; 25: 1492–1497.
Miyake K, Mibu H, Horiguchi M, Shirasawa E . Inflammatory mediators in postoperative aphakic and pseudophakic baboon eyes. Arch Ophthalmol 1990; 108: 1764–1767.
Hoekzema R, Murray PI, van Haren MA, de Hon FD, Kijlstra A . Aqueous humor interleukin-6 levels in uveitis. Invest Ophthalmol Vis Sci 1990; 31: 917–920.
Malecaze F, Chollet P, Cavrois E, Vita N, Arne JL, Ferrara P . Role of interleukin 6 in the inflammatory response after cataract surgery. An experimental and clinical study. Arch Ophthalmol 1991; 109: 1681–1683.
Hoekzema R, Murray PI, van Haren MA, Helle M, Kijlstra A . Analysis of interleukin-6 in endotoxin-induced uveitis. Invest Ophthalmol Vis Sci 1991; 32: 88–95.
Funatsu H, Yamashita H, Ikeda T, Mimura T, Eguchi S, Hori S . Vitreous levels of interleukin-6 and vascular endothelial growth factor are related to diabetic macular edema. Ophthalmology 2003; 110: 1690–1696.
Funatsu H, Yamashita H, Noma H, Mimura T, Yamashita T, Hori S . Increased levels of vascular endothelial growth factor and interleukin-6 in the aqueous humor of diabetics with macular edema. Am J Ophthalmol 2002; 133: 70–77.
Funatsu H, Yamashita H, Noma H, Shimizu E, Mimura T, Hori S . Prediction of macular edema exacerbation after phacoemulsification in patients with nonproliferative diabetic retinopathy. J Cataract Refract Surg 2002; 28: 1355.
Fishman D, Faulds G, Jeffery R, Mohamed-Ali V, Yudkin JS, Humphries S et al. The effect of novel polymorphisms in the interleukin-6 (IL-6) gene on IL-6 transcription and plasma IL-6 levels, and an association with systemic-onset juvenile chronic arthritis. J Clin Invest 1998; 102: 1369–1376.
Negi A, Browning AC, Vernon SA . Randomised controlled trial of a single per-operative triamcinolone injection compared to standard post operative steroid drops after uncomplicated phacoemulsification surgery. J Cataract Refract Surg 2006; 32: 468–474.
Lanzetta O, Menchini U, Virgili G . Scleral fixation intraocular lenses. An angiographic study. Retina 1998; 18: 515–520.
José-Manuel F-R, Joan V, Cristobal R, Cristina GWR . Platelet count and interleukin 6 gene polymorphism in healthy subjects. BMC Med Genet 2001; 2: 6.
Stark Jr WJ, Maumenee AE, Fagadau W, Datiles M, Baker CC, Worthen D et al. Cystoid macular edema in pseudophakia. Surv Ophthalmol 1984; 28 (Suppl): 442–451.
Cohen T, Nahari D, Cerem LW, Neufeld G, Levi BZ . Interleukin-6 induces the expression of vascular endothelial growth factor. J Biol Chem 1996; 271: 736–741.
Maruo N, Morita I, Shirao M, Murota S . IL-6 increases endothelial permeability in vitro. Endocrinology 1992; 131: 710–714.
Hoekzema R, Verhagen C, van Haren M, Kijlstra A . Endotoxin-induced uveitis in the rat. The significance of intraocular interleukin-6. Invest Ophthalmol Vis Sci 1992; 33: 532–539.
Acknowledgements
PC and AC thank the P and S Field Charitable Trust and Saint George's Hospital NHS and Medical School for their support. No competing interests.
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Masood, I., Negi, A., Vernon, S. et al. The −174G/C interleukin-6 promoter polymorphism influences the development of macular oedema following uncomplicated phacoemulsification surgery. Eye 21, 1412–1415 (2007). https://doi.org/10.1038/sj.eye.6702610
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DOI: https://doi.org/10.1038/sj.eye.6702610
