title: Lymphatic microvessel density as a predictive marker for the recurrence time of pterygium: a three-year follow-up study.
abstract: OBJECTIVE
  To investigate whether lymphatic microvessel density (LMVD) could be used as a predictive marker for the recurrence time of pterygia.
  
  
  METHODS
  This was a prospective case series study. Ninety-six patients with unilateral eye primary nasal pterygia were included. The patients were clinically evaluated to grade the severity of their pterygia (32 were Grade 1, 29 were Grade 2, and 35 were Grade 3) before they underwent bare sclera resection with the use of mitomycin C. Excised tissues from the 96 patients and the ten normal nasal conjunctiva obtained from age-matched donor eyeballs (controls) were immunostained with LYVE-1 and CD31 monoclonal antibodies to evaluate LMVD and blood microvessel density (BMVD). The patients were followed up for three years or until pterygium recurrence was identified, which was defined as fibrovascular regrowth past the limbus in a previously compromised area. The recurrence time (RT) for a pterygium was calculated, and its relationship with LMVD and/or BMVD was statistically analyzed.
  
  
  RESULTS
  In total, there were 24 cases of pterygium recurrence. The recurrence rate of Grade 1 was 28.1% (9/32), Grade 2 was 24.1% (7/29), and Grade 3 was 22.9% (8/35), as classified in the primary pterygium (p>0.05); the overall recurrence rate was 25% (24/96) for all patients during the three-year follow-up. In the tissue analysis, there were a small number of CD31 (+), LYVE-1(-) BMVD and only a few CD31 (weak), LYVE-1(+) LMVD in the ten normal nasal conjunctiva tissues. BMVD and LMVD increased significantly in the pterygium tissue compared to the control tissue and were significantly correlated with the width and area of pterygium in Grades 1-3 (all p values <0.05). RT was not correlated with BMVD or pterygium grade, but LMVD was significantly and negatively correlated with RT within each group and in the total patient cohort. Furthermore, we determined that an LMVD greater than 20 in the surgical specimens predicted pterygium recurrence.
  
  
  CONCLUSIONS
  The LMVD of surgical specimens is an independent risk factor and a valuable predictive factor for the recurrence time of pterygia.
authors: State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
authors: Haotian
authors: H
authors: Lin
authors: Lixia
authors: L
authors: Luo
authors: Shiqi
authors: S
authors: Ling
authors: Wan
authors: W
authors: Chen
authors: Zhaochuan
authors: Z
authors: Liu
authors: Xiaojian
authors: X
authors: Zhong
authors: Changrui
authors: C
authors: Wu
authors: Weirong
authors: W
authors: Chen
authors: Yizhi
authors: Y
authors: Liu
mesh_terms: D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D042583:Lymphangiogenesis; D042601:Lymphatic Vessels / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology / Q000503:physiopathology; D011446:Prospective Studies; D011625:Pterygium / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors
references: J Cell Mol Med. 2007 May-Jun;11(3):585-9
references: 17635650
references: Am J Ophthalmol. 1988 Dec 15;106(6):715-8
references: 3143266
references: Invest Ophthalmol Vis Sci. 2006 Jun;47(6):2430-7
references: 16723453
references: Ocul Surf. 2008 Jan;6(1):24-43
references: 18264653
references: Clin Cancer Res. 2004 Nov 1;10(21):7144-9
references: 15534085
references: Invest Ophthalmol Vis Sci. 2009 Apr;50(4):1613-8
references: 19029028
references: Am J Ophthalmol. 1984 Aug 15;98(2):225-8
references: 6383051
references: Ophthalmic Epidemiol. 1999 Sep;6(3):219-28
references: 10487976
references: Cornea. 2005 Jul;24(5):583-6
references: 15968165
references: Clin Exp Ophthalmol. 2009 Dec;37(9):874-83
references: 20092597
references: Arch Ophthalmol. 2012 Jun;130(6):735-42
references: 22801834
references: Invest Ophthalmol Vis Sci. 2007 Oct;48(10):4482-9
references: 17898269
references: Bosn J Basic Med Sci. 2010 Nov;10(4):307-13
references: 21108613
references: Acta Ophthalmol Scand. 1998 Apr;76(2):176-9
references: 9591948
references: Cornea. 2003 Apr;22(3):273-81
references: 12658100
references: Mol Vis. 2011;17:1694-700
references: 21738399
references: Br J Ophthalmol. 2007 Sep;91(9):1209-12
references: 17360734
references: Adv Ther. 2008 May;25(5):479-87
references: 18483701
references: Prog Retin Eye Res. 2004 Mar;23(2):195-228
references: 15094131
references: Br J Ophthalmol. 2001 Jul;85(7):782-4
references: 11423447
references: Zhonghua Yan Ke Za Zhi. 2009 Feb;45(2):115-21
references: 19573329
references: Invest Ophthalmol Vis Sci. 2007 Jun;48(6):2545-52
references: 17525183
references: Cornea. 1994 May;13(3):219-24
references: 8033571
references: Int J Mol Med. 2009 Apr;23(4):439-47
references: 19288018
references: Eye (Lond). 2007 Aug;21(8):1095-101
references: 16823458
references: Br J Ophthalmol. 1993 Jul;77(7):433-5
references: 8343473
references: Acta Ophthalmol. 2009 May;87(3):315-22
references: 18811642
references: Curr Eye Res. 2002 Jul;25(1):17-22
references: 12518239
references: Chin Med Sci J. 1993 Jun;8(2):84-8
references: 8292805
references: Ophthalmologica. 2008;222(5):308-16
references: 18617753
references: Chin Med J (Engl). 2010 Jul;123(13):1699-701
references: 20819632
references: Cancer Cell. 2004 Oct;6(4):333-45
references: 15488757
references: Ophthalmology. 2001 May;108(5):985-8
references: 11320032
references: Proc Natl Acad Sci U S A. 2005 Oct 25;102(43):15593-8
references: 16230630
references: Ocul Immunol Inflamm. 2003 Jun;11(2):115-22
references: 14533030
references: Invest Ophthalmol Vis Sci. 2007 Apr;48(4):1511-7
references: 17389479
references: Chin Med J (Engl). 2006 Aug 5;119(15):1308-10
references: 16919192
references: J Ocul Pharmacol Ther. 2011 Oct;27(5):481-5
references: 21992490