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Implications of bevacizumab on VEGF and endostatin in human choroidal neovascularization
  1. Olcay Tatar (olcaytatar{at}yahoo.com),
  2. Kei Shinoda,
  3. Edwin Kaiserling,
  4. Carl Claes,
  5. Claus Eckardt,
  6. Tillmann Eckert,
  7. Vicky Boeyden,
  8. Grazia Pertile,
  9. Efdal Yoeruek,
  10. Peter Szurman,
  11. Karl U Bartz-Schmidt,
  12. Salvatore Grisanti (salvatore.grisanti{at}med.uni-tuebingen.de)
  1. University Eye Clinic at the Centre for Ophthalmology of the Eberhard-Karls-University, Tuebingen, Germany
  2. Laboratory of Visual Physiology, National Institute of Sensory Organs, Tokyo, Japan
  3. Department of Pathology, Eberhard-Karls University, Tuebingen, Germany
  4. AZ- Sint Augustinus Hospital, Department Achtersegment, Antwerp, Belgium
  5. Augenklinik der Staedtischen Kliniken, Frankfurt am Main, Germany
  6. Augenklinik der Staedtischen Kliniken, Frankfurt am Main, Germany
  7. AZ- Sint Augustinus Hospital, Department Achtersegment, Antwerp, Belgium
  8. Ospedale Sacro Cuore, Italy
  9. University Eye Clinic at the Centre for Ophthalmology of the Eberhard-Karls-University, Tuebingen, Germany
  10. University Eye Clinic at the Centre for Ophthalmology of the Eberhard-Karls-University, Tuebingen, Germany
  11. University Eye Clinic at the Centre for Ophthalmology of the Eberhard-Karls-University, Tuebingen, Germany
  12. Department of Ophthalmology at the University of Luebeck, Luebeck, Germany

    Abstract

    Aim: To evaluate implications of intravitreal bevacizumab on proangiogenic vascular endothelial growth factor (VEGF) with regard to the endogenous angiogenesis inhibitor endostatin in human choroidal neovascularization (CNV) secondary to age-related macular degeneration.

    Methods: Retrospective review of an interventional case series of forty-eight patients who underwent full macular translocation surgery with removal of CNV. Twenty five patients were treated with intravitreal bevacizumab injection 1 to 154 days prior to surgery (bevacizumab CNV). Twenty-three CNV without any kind of previous treatment were used as controls (control CNV). CNV were stained for CD34, cytokeratin18, VEGF, endostatin and E-selectin. "Predominance score of VEGF over endostatin" (PS) was defined by the difference between VEGF and endostatin staining scores.

    Results: Bevacizumab CNV disclosed weaker VEGF expression in endothelial cells (p=0.0245) but significantly more intense endostatin in retina pigment epithelium (RPE) (p=0.0001) and stroma (p<0.0001). Consequently, PS was significantly lower in RPE (p=0.02), vessels (p=0.03) and stroma (p=0.0004) in bevacizumab CNV. Intensity of E-selectin expression in bevacizumab CNV was comparable to that in control CNV.

    Conclusions: A shift within the angiogenic balance in terms of decreased VEGF predominance over endostatin is detected in human CNV treated with bevacizumab.

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