Article
Early effects of triamcinolone acetonide on VEGF and PEDF in human choroidal neovascularization
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Published: | May 30, 2012 |
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Objective: To evaluate the early effects of verteporfin photodynamic therapy (PDT) and triamcinolone acetonide (TA) combination therapy on pigment epithelium derived factor (PEDF) expression with regard to vascular endothelial growth factor (VEGF) in human choroidal neovascularization (CNV) secondary to age related macular degeneration.
Methods: Retrospective review of interventional series of 36 patients who underwent macular translocation with CNV extraction. Six patients were treated with intravitreal PDT-TA combination therapy (PDT-TA CNV) 3 to 9 days preoperatively. Twenty-six CNV without previous therapy (control CNV) and 4 CNV excised 3 days after PDT (PDT CNV) were used as control. CNV were stained for cytokeratin18, CD34, VEGF and PEDF.
Results: VEGF was stronger in retina pigment epithelium (RPE) (p=0.0002) and stroma of PDT-TA CNV (0.0103) and RPE of PDT CNV (p=0.0004) than control CNV. VEGF in PDT CNV and PDT-TA CNV did not show any significant change with respect to each other. PEDF was weaker in stroma of PDT CNV than in control CNV (p=0.01). PEDF expression in stroma of PDT-TA CNV was comparable to control CNV (p=0.9), however, was stronger than PDT CNV (p=0.03). VEGF predominance over PEDF was significantly higher in RPE of PDT CNV but not in PDT+TA CNV when compared to control CNV.
Conclusions: Administration of TA as adjuvant to PDT does not suppress the increase in VEGF expression but inhibits the decrease in PEDF expression, therefore prevents VEGF predominance over PEDF early after PDT.