Influence of verteporfin photodynamic therapy on inflammation in human choroidal neovascular membranes secondary to age-related macular degeneration

Retina. Jul-Aug 2007;27(6):713-23. doi: 10.1097/IAE.0b013e318042d3b0.

Abstract

Purpose: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antigens, CD / metabolism
  • Antigens, CD34 / metabolism
  • Antigens, Differentiation, Myelomonocytic / metabolism
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology
  • Choroidal Neovascularization / pathology
  • Choroiditis / drug therapy*
  • Choroiditis / etiology
  • Choroiditis / pathology
  • Endoglin
  • Female
  • Humans
  • Immunoenzyme Techniques
  • Keratin-18 / metabolism
  • Leukocyte Common Antigens / metabolism
  • Leukocytes / metabolism
  • Leukocytes / pathology
  • Macrophages / metabolism
  • Macrophages / pathology
  • Macular Degeneration / complications*
  • Male
  • Middle Aged
  • Photochemotherapy*
  • Photosensitizing Agents / therapeutic use*
  • Porphyrins / therapeutic use*
  • Receptors, Cell Surface / metabolism
  • Retrospective Studies
  • Thy-1 Antigens / metabolism
  • Verteporfin

Substances

  • Antigens, CD
  • Antigens, CD34
  • Antigens, Differentiation, Myelomonocytic
  • CD68 antigen, human
  • ENG protein, human
  • Endoglin
  • Keratin-18
  • Photosensitizing Agents
  • Porphyrins
  • Receptors, Cell Surface
  • Thy-1 Antigens
  • Verteporfin
  • Leukocyte Common Antigens
  • PTPRC protein, human