Effect of verteporfin photodynamic therapy on endostatin and angiogenesis in human choroidal neovascular membranes.
OBJECTIVE
To evaluate the effect of verteporfin photodynamic therapy (PDT) on endostatin with regard to expression of vascular endothelial growth factor (VEGF) in human choroidal neovascular membranes (CNVs) secondary to age-related macular degeneration.


METHODS
A retrospective review of an interventional case series of 68 patients who underwent removal of CNV. 29 patients were treated with PDT 3-655 days before surgery. 39 CNVs without previous treatment were used as controls. CNVs were stained for CD34, CD105, Ki-67, cytokeratin 18, endostatin, E-selectin and VEGF. "Predominance score of VEGF over endostatin" (mean) was defined as the difference between VEGF and endostatin staining scores.


RESULTS
In four CNVs treated by PDT 3 days previously, PS was significantly higher in the retinal pigment epithelium (mean = 2.5, p = 0.006) and stroma (mean = 2, p = 0.015) than in the control group (mean = 0). At longer post-PDT intervals, PS was significantly decreased in the retinal pigment epithelium (mean = 0, p = 0.019) and stroma (mean = 0, p = 0.015). Proliferative activity was high (p = 0.023), but mostly related to inflammatory cells. PDT did not influence E-selectin expression significantly.


CONCLUSIONS
VEGF predominance over endostatin early after PDT might contribute to enhanced angiogenic activity associated with recurrences. Strategies upregulating or replacing endostatin early after PDT might increase the effectiveness of PDT.
Tatar
Olcay
O
University Eye Hospital, Centre for Ophthalmology of Eberhard-Karls University, Schleichstrasse 12-15, 72076 Tuebingen, Germany.
Shinoda
Kei
K
Adam
Annemarie
A
Eckert
Tillmann
T
Eckardt
Claus
C
Lucke
Klaus
K
Deuter
Christoph
C
Bartz-Schmidt
Karl Ulrich
KU
Grisanti
Salvatore
S
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism*; D019040:E-Selectin / Q000378:metabolism; D043169:Endostatins / Q000378:metabolism*; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D010857:Pigment Epithelium of Eye / Q000378:metabolism; D011166:Porphyrins / Q000627:therapeutic use; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism*; D000077362:Verteporfin
D019040:E-Selectin; D043169:Endostatins; D017319:Photosensitizing Agents; D011166:Porphyrins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000077362:Verteporfin