Unveiling the mechanisms of proliferative diabetic retinopathy: PVAT-derived inflammatory and angiogenic mediators as potential biomarkers in vitreous and serum

OBJECTIVES This study aimed to explore the role of perivascular adipose tissue (PVAT)-derived mediators in vitreous and serum samples from patients with proliferative diabetic retinopathy (PDR). METHODS Serum and vitreous samples were prospectively collected between February and April 2023 from 22 patients undergoing surgery for PDR and 22 patients with macular hole (MH) or epiretinal membrane (ERM) as the control group. The levels of adiponectin (ADP), visfatin (VF), adipocyte fatty acid-binding protein (a-FABP), and apelin were analyzed. RESULTS The serum and vitreous ADP levels in the PDR group were significantly lower than those in the control group (MH-ERM) ( p =  0.003 and p <  0.001). In contrast, the serum and vitreous apelin levels were significantly greater in the PDR group ( p <  0.001). Serum and vitreous a-FABP levels were significantly increased in the PDR group compared with those in the control group ( p =  0.025 and p =  0.002,). VF levels in the serum and vitreous were significantly greater in the PDR group than in the control group ( p =  0.003 and p <  0.001, respectively). CONCLUSION Changes in ADP, apelin, a-FABP, and VF levels in serum and vitreous suggest their potential as novel biomarkers and therapeutic targets for PDR classification, disease progression assessment, and treatment strategies.