ABSTRACT
The role of cytokines in the pathogenesis of diabetic retinopathy and mechanism of action of laser coagulation of the retina were investigated. A total of 110 patients with insulin-dependent diabetes mellitus without clinical signs of diabetic retinopathy and at various stages of its development (subclinical, manifest preproliferative, and proliferative) were observed. Twenty-four of them were subjected to laser coagulation of the retina and/or vitrectomy. Control group consisted of 30 healthy donors. Ten cytokines (alpha-IFN, gamma-IFN, GM-CSF, TGF-beta 1, Il-1, Il-4, Il-6, Il-6sR, TNF alpha) were measured in the serum, lacrimal fluid, and vitreous and subretinal fluid collected during operations. The data indicate that excessive or insufficient local and/or systemic production of at least seven cytokines (TNF alpha, gamma-IFN, Il-6, Il-pR, alpha-IFN, Il-8, and RGF-beta 1) can affect the retinal involvement in the pathological process and development of proliferative retinopathy in patients with insulin-dependent diabetes mellitus. The authors defined the criteria which can be used in clinical practice for predicting the manifestation of diabetic retinopathy, progress of the pathological process with formation of proliferative diabetic retinopathy, and the results of treatment by laser coagulation of the retina. The authors consider early immunorehabilitations of diabetics with the aim of preventing the development and progress of diabetic retinopathy a promising approach to treatment.
