Abstract
Background. The importance of ischemia and hypoxia in the development of diabetic retinopathy (DR) has been established, which makes the study of the content of the main hypoxia marker – hypoxia-inducible factor-α (HIF-1α) in intraocular fluid (IOP) promising. Aim: to determine the content of the hypoxia marker - hypoxia-inducible factor-α in intraocular fluid and its relationship with the progression of diabetic retinopathy. Materials and methods. 110 patients with type 2 diabetes mellitus were examined, who were divided into groups according to the DR stage according to the International Classification (2003): 1st – without retinopathy (15 eyes), 2nd – with initial non-proliferative DR (NPDR; 40 eyes), 3rd – with moderate NPDR (25 eyes), 4th – with severe NPDR (12 eyes) and 5th – with proliferative DR (PDR; 18 eyes). The control group included 25 people of the appropriate age and sex who did not have diabetes and DR. The content of HIF-1α (pg/ml) was determined in the IOF obtained during cataract phacoemulsification surgery by enzyme-linked immunosorbent assay. For statistical analysis of the results, the EZR v.1.54 package (Austria) was used. Results. A direct relationship between the duration of diabetes and the stages of DR was found: the threshold for the occurrence of DR was more than 11.5 years, for PDD – more than 14 years (p<0.001). A direct relationship between the increase in the content of HIF-1α in the IOF and the DR stages was also established: the threshold for the occurrence of DR was more than 118 pg/ml (p<0.001). The predictive thresholds for the content of HIF-1α in the IOF by the DR stages were calculated: less than 113.8 pg/ml in diabetes without DR, 113.8-247.8 pg/ml – in mild NPDR, 247.9-408.4 pg/ml – in moderate DR, 408.5-509.3 – in severe NPDR and more than 509.3 pg/ml – in PDR. Conclusion. A direct relationship between the increase in HIF-1α content in the IOF and the progression of DR was established and the principle possibility of its use as a DR biomarker was confirmed