Verteporfin photodynamic therapy induced apoptosis in choroidal neovascular membranes.
OBJECTIVE
To evaluate the impact of verteporfin photodynamic therapy (PDT) on the induction of apoptosis in choroidal neovascular membranes (CNV) secondary to age related macular degeneration.


METHODS
Retrospective review of 22 surgically excised CNV. 12 of these patients had been treated with PDT 3-146 days previously. Apoptotic cells were detected with the TUNEL technique and compared to the expression of CD34 (endothelial cells, EC), CD105 (activated endothelial cells), Ki-67 (proliferation marker), and cytokeratin18 (retinal pigment epithelial cells, RPE).


RESULTS
CNV excised 3 days after PDT were characterised both by collapsed and patent vessels. The EC displayed a statistical significant positive TUNEL reaction when compared to the remaining treated CNV (p < 0.001) and untreated CNV (P = 0.002). The proliferative activity was reduced. CNV excised 1-5 months after PDT displayed a patent vascularisation and high proliferative activity. All membranes either treated or untreated disclosed only sporadic TUNEL positive cells within the stroma and the RPE.


CONCLUSIONS
Verteporfin PDT leads to selective and effective damage of EC within CNV. Both patent and occluded vessels were lined by apoptotic EC. This finding and the increased expression of proliferation marker at later time points suggest that revascularisation after PDT is caused by angiogenesis rather than recanalisation.
Petermeier
K
K
Univerisity Eye Clinic at the Centre for Ophthalmology, Eberhard-Karls University Tuebingen, Schleichstrasse 12-16, 72076 Tuebingen, Germany.
Tatar
O
O
Inhoffen
W
W
Völker
M
M
Lafaut
B A
BA
Henke-Fahle
S
S
Gelisken
F
F
Ziemssen
F
F
Bopp
S
S
Bartz-Schmidt
K U
KU
Grisanti
S
S
D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000187:drug effects* / Q000528:radiation effects; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology / Q000601:surgery; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D006801:Humans; D020287:In Situ Nick-End Labeling; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D012189:Retrospective Studies; D000077362:Verteporfin; D014792:Visual Acuity
D017319:Photosensitizing Agents; D011166:Porphyrins; D000077362:Verteporfin