Influence of verteporfin photodynamic therapy on inflammation in human choroidal neovascular membranes secondary to age-related macular degeneration.
OBJECTIVE
To examine the short- and long-term consequences of verteporfin photodynamic therapy (PDT) on inflammation with regard to infiltration of macrophages and leukocytes and expression of thy-1 in human choroidal neovascularization membranes (CNV) secondary to age-related macular degeneration (AMD).


METHODS
Retrospective review of an interventional case series of 43 patients who underwent removal of CNV. Twenty patients were treated with PDT 3 to 246 days preoperatively. Twenty-three CNV without previous treatment were used as control. CNV were stained for CD34, CD105, cytokeratin 18, Ki-67, thy-1, an endothelial cell glycoprotein known to be upregulated only by inflammatory cytokines, CD68 (macrophages), and CD45 (common leukocyte antigen).


RESULTS
Specimens treated by PDT 3 days previously showed significantly reduced endothelial thy-1 expression (P = 0.008), leukocyte (P=0.04) and macrophage (P=0.0063) infiltration, and proliferative activity (P=0.02) compared to control CNV. Specimens at longer intervals after PDT, in contrast, disclosed a significantly increased expression of thy-1 (P=0.004), infiltration with leukocytes (P=0.044) and macrophages (P=0.01), and proliferative activity (P=0.03) compared to CNV excised 3 days after PDT.


CONCLUSIONS
The rebound effect after PDT seems to be based on an inflammatory response that contributes to enhanced proliferation. These data support the need for an anti-inflammatory therapy as adjuvant to PDT.
Tatar
Olcay
O
University Eye Hospital at the Center for Ophthalmology, Eberhard-Karls University Tuebingen, Germany.
Adam
Annemarie
A
Shinoda
Kei
K
Yoeruek
Efdal
E
Szurman
Peter
P
Bopp
Silvia
S
Eckardt
Claus
C
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; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D002833:Choroiditis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D000071063:Endoglin; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D053538:Keratin-18 / Q000378:metabolism; D017493:Leukocyte Common Antigens / Q000378:metabolism; D007962:Leukocytes / Q000378:metabolism / Q000473:pathology; D008264:Macrophages / Q000378:metabolism / Q000473:pathology; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D011166:Porphyrins / Q000627:therapeutic use*; D011956:Receptors, Cell Surface / Q000378:metabolism; D012189:Retrospective Studies; D018800:Thy-1 Antigens / Q000378:metabolism; D000077362:Verteporfin; D000097382:CD68 Molecule
D015703:Antigens, CD; D018952:Antigens, CD34; D015214:Antigens, Differentiation, Myelomonocytic; D000071063:Endoglin; D053538:Keratin-18; D017493:Leukocyte Common Antigens; D017319:Photosensitizing Agents; D011166:Porphyrins; D011956:Receptors, Cell Surface; D018800:Thy-1 Antigens; D000077362:Verteporfin; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C064206:ENG protein, human; C516769:PTPRC protein, human