Massive vascular endothelium growth factor (VEGF) expression in Eales' disease.
Massive vascular endothelium growth factor (VEGF) expression in Eales' disease.
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DOI：
10.1055/s-2002-30662
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发表时间：
2002-04
影响因子：
0.8
通讯作者：
Y. Perentes;C. Chan;E. Bovey;S. Uffer;C. Herbort
中科院分区：
文献类型：
--
作者：
Y. Perentes;C. Chan;E. Bovey;S. Uffer;C. Herbort
背景Eales病是一种特发性视网膜血管炎和血管闭塞过程，伴有广泛的视网膜新生血管和玻璃体破裂。视网膜新生血管的产生是值得进一步研究的疾病的特殊方面之一。我们报告了一个Eales病的情况下，已经发展了三十多年，在一只眼睛的典型临床表现，而另一只眼睛必须摘除，因为终端新生血管性青光眼，从而允许病理检查。方法采用玻璃体切割、环扎、冷凝、眼内激光等方法治疗功能性右眼。摘除无功能性肺结核左眼，并使用抗血管内皮生长因子、T细胞、B细胞和Müller细胞的抗体进行组织病理学和免疫组织化学检查。结果：在炎症反应处理后，手术右眼的进展是有利的。左眼的组织病理学检查显示前房角因虹膜发红、牵引性视网膜脱离、视网膜前、视网膜内和视网膜下新生血管膜和玻璃体破裂而闭塞。在视网膜新生血管膜的水平上发现了弥漫性的抗VEGF免疫染色阳性。视网膜表现出明显的Müller细胞免疫染色，表明广泛的神经胶质增生，并且在眼睛中发现主要是B细胞浸润。结论Eales'病血管增生与VEGF的高表达密切相关。与其他诱导新生血管形成的条件相比，VEGF表达增加可能解释Eales病中新生血管生长的严重性和反复玻璃体破裂的倾向。
BACKGROUND Eales' disease is an idiopathic retinal vasculitic and vaso-occlusive process complicated by extensive retinal neovascularisation and vitreous hemorrhages. The great propensity to produce retinal neovessels is one of the particular aspects of the disease that deserves to be further investigated. We report a case of Eales' disease having evolved over more than three decades, with a typical clinical presentation in one eye, while the other eye had to be enucleated because of a terminal neovascular glaucoma, thus allowing pathological examination. METHODS The functional right eye was treated by vitrectomy, cerclage, cryocoagulation and endolaser. The non-functional phthitic left eye was enucleated and submitted for histopathological and immunohistochemical examination using antibodies against vascular endothelial growth factor, T-cells, B-cells and Müller cells. RESULTS Evolution was favourable in the operated right eye, following management of the inflammatory reaction. The histopathological examination of the left eye revealed an occlusion of the anterior chamber angle by rubeosis iridis, tractional retinal detachments, pre-, intra- and sub-retinal neovascular membranes, and vitrous hemorrhages. Diffuse positive anti-VEGF immunostaining was found at the level of the retinal neovascular membranes. The retina exhibited prominent Müller cell immunostaining, indicating extensive gliosis, and predominantly B cell infiltrates were found in the eye. CONCLUSION The present study indicates a close relationship between the prominent neovascular proliferation in Eales' disease and the intense expression of VEGF. The increased expression of VEGF, when compared to other conditions inducing neovascularisation, might explain the severity of neovascular growth and the propensity of repeated vitrous hemorrhages in Eales' disease.