title: Histopathologic Characterization of the Expression of Vascular Endothelial Growth Factor in a Case of Retinopathy of Prematurity Treated With Ranibizumab.
abstract: OBJECTIVE
  To characterize the expression of vascular endothelial growth factor (VEGF) in a patient with retinopathy of prematurity (ROP) treated with ranibizumab (Case 1) and compare it with a case of ROP without treatment (Case 2), a case of a premature baby without ROP (Case 3), and a case of a baby without history of ROP or prematurity (Case 4).
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  The eyes of the deceased babies were removed postmortem and were sent to the Florida Lions Ocular Pathology Laboratory, where they were processed. The specimens were immunostained using an antibody against VEGF.
  
  
  RESULTS
  All eyes except for the eyes in Case 4 disclosed positive VEGF staining. Positive staining was present within the nerve fiber layer, inner plexiform layer, and inner and outer nuclear layers and within the spindle-shaped cell population in the vanguard in Case 1. In the posterior pole, positive staining was only observed at the level of the nerve fiber layer. This case also demonstrated less positive staining when compared with Case 2, where positive staining was found within all layers of the retina.
  
  
  CONCLUSIONS
  Less VEGF staining was observed within the retina of the eyes treated with ranibizumab when compared with the VEGF staining in Case 2. This supports the idea that anti-VEGF agents are effective in reducing the amount of VEGF present in the retina. Furthermore, the fact that some expression of VEGF remains in the immature retina after injection supports the idea that anti-VEGF agents can suppress uncontrolled neovascularization without completely blocking the vascular drive for the vascularization of the immature retina.
authors.affiliation: Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Maria P
authors.initials: MP
authors.lastname: Fernandez
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Audina M
authors.initials: AM
authors.lastname: Berrocal
authors.affiliation: University of South Carolina School of Medicine Greenville, South Carolina.
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Goff
authors.affiliation: Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Ghassibi
authors.affiliation: Austin Retina Associates, Austin, Texas; University of Texas Health Science Center, San Antonio, Texas.
authors.forename: C Armitage
authors.initials: CA
authors.lastname: Harper
authors.affiliation: Department of Surgery, Ophthalmology Service, Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Eva
authors.initials: E
authors.lastname: Chou
authors.affiliation: Newborn Intensive Care Unit & High-Risk Infant Specialty Transport Service, Dell Children's Medical Center, Austin, Texas.
authors.forename: Simon K
authors.initials: SK
authors.lastname: Michael
authors.affiliation: Davis Eye Center, University of California, Sacramento, California.
authors.forename: Justin
authors.initials: J
authors.lastname: Hellman
authors.affiliation: Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: sdubovy@med.miami.edu.
authors.forename: Sander R
authors.initials: SR
authors.lastname: Dubovy
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D000069579:Ranibizumab / Q000008:administration & dosage*; D012160:Retina / Q000378:metabolism / Q000473:pathology*; D012178:Retinopathy of Prematurity / Q000175:diagnosis* / Q000188:drug therapy / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000096:biosynthesis*
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab