Expression of VEGF and PEDF in choroidal neovascular membranes following verteporfin photodynamic therapy.
OBJECTIVE
To examine the impact of photodynamic therapy (PDT) on pigment epithelium derived factor (PEDF) expression in human choroidal neovascularization (CNV) membranes with regard to vascular endothelial growth factor (VEGF) expression.


METHODS
Interventional case series.


METHODS
Retrospective review of interventional case series of 42 patients (42 eyes) who underwent removal of CNV. CNV was secondary to age-related macular degeneration (AMD) in all cases. Fifteen patients were treated with PDT, 3 to 246 days before surgery. CNV were stained for CD34, CD105, cytokeratin 18, VEGF, and PEDF. Twenty-seven CNV without previous treatment were used as control.


RESULTS
Specimens without pretreatment disclosed varying degrees of vascularization, VEGF, and PEDF expression by different cells. Specimens treated by PDT, three days previously showed mostly occluded vessels lined with damaged endothelial cells (EC). In contrast, specimens excised at later time points after PDT were highly vascularized with healthy EC. This chronology was associated with an impressive VEGF immunoreactivity increased considerably in retinal pigment epithelial cells as well as significantly reduced PEDF expression in EC and stroma.


CONCLUSIONS
PDT induces a selective vascular damage in CNV. The effectiveness of PDT, however, seems to be jeopardized by a rebound effect initiated by an enhanced VEGF and reduced PEDF expression in CNV.
Tatar
Olcay
O
University Eye Clinic, Centre for Ophthalmology, Eberhard-Karls University, Tuebingen, Germany.
Adam
Annemarie
A
Shinoda
Kei
K
Stalmans
Peter
P
Eckardt
Claus
C
Lüke
Matthias
M
Bartz-Schmidt
Karl Ulrich
KU
Grisanti
Salvatore
S
D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism*; D000071063:Endoglin; D004730:Endothelium, Vascular / Q000378:metabolism; D005136:Eye Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007633:Keratins / Q000378:metabolism; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000378:metabolism*; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D010857:Pigment Epithelium of Eye / Q000378:metabolism; D011166:Porphyrins / Q000627:therapeutic use*; D011956:Receptors, Cell Surface / Q000378:metabolism; D012189:Retrospective Studies; D015843:Serpins / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D000077362:Verteporfin; D000099174:Pigment Epithelium-Derived Factor
D015703:Antigens, CD; D018952:Antigens, CD34; D000071063:Endoglin; D005136:Eye Proteins; D007633:Keratins; D009414:Nerve Growth Factors; D017319:Photosensitizing Agents; D011166:Porphyrins; D011956:Receptors, Cell Surface; D015843:Serpins; D042461:Vascular Endothelial Growth Factor A; D000077362:Verteporfin; D000099174:Pigment Epithelium-Derived Factor; C064206:ENG protein, human; C467484:VEGFA protein, human