Dynamic changes of aqueous matrix metalloproteinases and imaging correlation in retinal vein occlusion following ranibizumab therapy

Purpose:
To investigate changes in aqueous humor matrix metalloproteinases (MMPs) after intravitreal ranibizumab (IVR) therapy, and their correlations with imaging parameters in retinal vein occlusion (RVO).

Methods: Aqueous humor samples from 28 patients with RVO 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 nonresponders 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 nonresponders. 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 humor levels of 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.