Expression levels of aldose reductase enzyme, vascular endothelial growth factor, and intercellular adhesion molecule-1 in the anterior lens capsule of diabetic cataract patients

Purpose: To compare the levels of aldose reductase (ALR) enzyme, intercellular adhesion molecule-1 (ICAM-1), and vascular endothelial growth factor (VEGF) in the anterior lens capsule of diabetic versus nondiabetic patients. Setting: Alexandria Main University Hospital, Alexandria, Egypt. Design: Prospective case-control study. Methods: The study enrolled patients undergoing cataract extraction and divided them into 3 groups: eyes that had proliferative diabetic retinopathy (PDR), eyes that had nonproliferative diabetic retinopathy (NPDR), and nondiabetic eyes. The anterior lens capsules were obtained by performing femtosecond laser–assisted capsulorhexis. Concentrations of ALR, ICAM-1, and VEGF in the lens capsule specimens were measured using human enzyme–linked immunosorbent assay. Results: This study comprised 200 patients (200 eyes); 51 eyes had PDR, 49 eyes had NPDR, and 100 eyes were nondiabetic. The mean ALR, ICAM-1, and VEGF levels in the anterior capsule of diabetic group were 2.84 nanogram (ng)/mL ± 0.51 (SD), 87.73 ± 22.84 picogram (pg)/mL, and 75.53 ± 14.95 pg/mL, respectively; whereas, in the nondiabetic group, they were 1.44 ± 0.17 ng/mL, 35.45 ± 2.8 pg/mL, and 33.55 ± 5.47 pg/mL, respectively. In comparing the concentrations of these mediators, both the PDR and NPDR groups had significantly higher levels compared with the nondiabetic eyes (P < .001). In addition, eyes with PDR had significantly higher levels of these mediators than eyes with NPDR (P < .001). Conclusion: The concentrations of ALR, ICAM-1, and VEGF in the anterior lens capsule of diabetic patients are significantly higher than those of nondiabetics. A significantly higher level of 3 mediators in eyes with PDR compared with those with NPDR might allow the use of them as a biomarker for severity of diabetic retinopathy.Dr. Piñero has been supported by the Ministry of Economy, Industry and Competitiveness of Spain within the program Ramón y Cajal, RYC-2016-20471