THE ROLE OF ANGIOPOIETIN SYSTEM IN HEMOPHTHALMOS EMERGENCE AFTER VITREORETINAL SURGERY IN CASES OF DIABETIC RETINOPATHY AND TYPE 2 DIABETES MELLITUS

Rykov S. O., Lytvynenko S. S., Mohilevskyi S. Yu.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The diabetic retinopathy (DR) is a nonspecific vascular event for both type 1 and type 2 diabetes mellitus (DM), which often leads to shortsightedness and blindness. In cases of the DR and type 2 diabetes mellitus (DM2), a vicious circle is being formed with engagement of angiopoietins (Ang-1and Ang-2); it may be significant for retinal vascular abnormalities and, in particular, for hemophthalmos development after advanced vitreoretinal surgery. Purpose of the study. To analyze the role of angiopoietin system in hemophthalmos emergence after vitreoretinal surgery in cases of diabetic retinopathy and type 2 diabetes mellitus.Subjects and methods of the study. 118 patients (118 eyes) with DM2 and DR participated in the study. They were divided into 3 groups. I group: with mild non-proliferative DR (NPDR; 28 eyes); II group: with moderate or severe NPDR (49 eyes); III group: with proliferative DR (PDR; 41 eyes). The patients’ age varied between 44 and 84 years with 52 men (44.1%) and 66 women (55.9%). All patients underwent 25G closed subtotal vitrectomy with panretinal photocoagulation (PRP) and either 18% gas-air tamponade (C3F8) or BSS plus solution in the vitreous cavity. Ang1and Ang-2 content had been identified in the vitreous body (VB) by means of immunoenzyme method. Findings. In cases of the DR and DM2, angiopoietin content in the VB was multiples higher than a statistically average norm (in 5.7-10.2 times higher; p<0,001). By DR stages, angiopoietin content increase (with higher relevance for the Ang-2) was observed from the NPDR to PDR cases. There was no difference in the angiopoietin content by sex. Patients with the DM2 3rd severity degree had higher angiopoietin content in comparison with the patients with the 2nd severity degree. The angiopoietin level decreased with improvement of the DM2 status as per HbA1c (p<0,001) level with higher relevance for the Ang-2. Spearman rank correlation analysis showed presence of direct original correlation of angiopoietin content in CT with age, DM2 duration, ETDRS letter score, blood level of HbA1c and their linkage to the best corrected visual acuity (p<0,01). Subject to hemophthalmos emergence, only the PDR patients had higher Ang-1 content, whereas all patients had excessive Ang-2 content (in 1.1-1.3 times higher; p<0,05). Conclusions. The traced connection between angiopoietin system and DR cases of DM2 patients, as well as the Ang-2 impact on post-operative hemophthalmos development, indicates good perspectives for usage of the Ang-2 or its receptors blockade to prevent hemophthalmos emergence after a vitrectomy.

Closed subtotal vitrectomy, post-operative hemophthalmos, angiopoietins, diabetic retinopathy, type 2 diabetes mellitus.

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«Bulletin of problems biology and medicine» Issue 4 (162), 2021 year, 165-171 pages, index UDK 617.747‐003.215: 617.735-007+617.735-002+616.379-008

10.29254/2077-4214-2021-4-162-165-171