Aim: 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.
- AMD, age-related macular degeneration
- CNV, choroidal neovascular membrane
- Mab, monoclonal antibody
- PDT, photodynamic therapy
- RPE, retinal pigment epithelium
- VEGF, vascular endothelial growth factor
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Published Online First 20 September 2006
Funding: This work was supported by a grant from Vision 100 Foundation and a grant from Jung Foundation.
Competing interests: None declared.