Histopathology of Neovascular Tissue From Eyes With Proliferative Diabetic Retinopathy After Intravitreal Bevacizumab Injection
Histopathology of Neovascular Tissue From Eyes With Proliferative Diabetic Retinopathy After Intravitreal Bevacizumab Injection
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DOI：
10.1016/j.ajo.2010.03.016
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发表时间：
2010-08-01
影响因子：
4.2
通讯作者：
Ishibashi, Tatsuro
中科院分区：
文献类型：
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作者：
Kohno, Ri-Ichiro;Hata, Yasuaki;Ishibashi, Tatsuro
目的：检查单次玻璃体内注射贝伐单抗对增殖性糖尿病视网膜病变 (PDR) 眼新生血管的组织病理学影响。设计：干预性病例系列和实验室研究。方法：玻璃体内注射贝伐单抗（1.25 mg/眼）两天后，进行玻璃体切除术或小梁切除术，以治疗与增生性糖尿病视网膜病变 (PDR) 相关的 PDR 或新生血管性青光眼 (NVG)。 PDR。将 10 个手术切除的视网膜前增殖组织和 6 个含有小梁网的深部巩膜瓣固定在 2% 戊二醛或 4% 多聚甲醛中，并进行透射电子显微镜分析、免疫组织化学分析和末端脱氧尿苷三磷酸 (dUTP) 缺口末端标记染色。手术切除 PDR 和 NVG 患者的 2 例视网膜前增殖组织和 2 例深部巩膜瓣，但术前未玻璃体内注射贝伐单抗（IVB）作为对照。 结果：在对照组织中，血管内皮细胞具有许多开窗并伴有周细胞。玻璃体内注射贝伐珠单抗后，在组织中经常观察到凋亡的血管内皮细胞，而在对照组织中未观察到凋亡的血管内皮细胞。此外，在玻璃体内注射贝伐单抗后，在来自增殖组织或小梁网的新形成的血管中没有观察到明显的开窗。在玻璃体内注射贝伐单抗后，在 PDR 和 NVG 组织中，在新形成的血管中观察到平滑肌肌动蛋白的过度表达，这表明与对照组织相比，治疗可能增加了脉管系统上的周细胞。 结论：玻璃体内注射贝伐单抗可能会诱导 PDR 或 NVG 组织中未成熟的新形成血管发生变化，导致内皮细胞凋亡和血管退化，同时通过增加周细胞来诱导过早血管的正常化覆盖并减少血管开窗。 （美国眼科杂志 2010 年；150：223-229。(C) 2010 年，Elsevier Inc. 保留所有权利。）
PURPOSE: To examine the histopathologic effect of a single intravitreal injection of bevacizumab on newly formed vessels in eyes with proliferative diabetic retinopathy (PDR).DESIGN: Interventional case series and laboratory investigation.METHODS: Two days after intravitreal injection of bevacizumab (1.25 mg/eye), pars plana vitrectomy or trabeculectomy was performed for the treatment of PDR or neovascular glaucoma (NVG) associated with PDR. Ten surgically removed preretinal proliferative tissues and 6 deep scleral flaps containing trabecular meshwork were fixed in 2% glutaraldehyde or 4% paraformaldehyde and were subjected to transmission electron microscopic analysis, immunohistochemical analysis, and terminal deoxyuridiine triphosphate (dUTP) nick-end labeling staining. Two surgically removed preretinal proliferative tissues and 2 deep scleral flaps from patients with PDR and NVG, but without preoperative intravitreal injection of bevacizumab (IVB), served as controls.RESULTS: In control tissues, vascular endothelial cells possessed many fenestrations and were accompanied by pericytes. Apoptotic vascular endothelial cells frequently were observed in tissue after intravitreal injection of bevacizumab, whereas they were not observed in control tissues. Additionally, no apparent fenestration was observed in newly formed vessels from either proliferative tissue or trabecular meshwork after intravitreal injection of bevacizumab. In both PDR and NVG tissues after intravitreal injection of bevacizumab, overexpression of smooth muscle actin was observed in newly formed vessels, suggesting that the treatment may have increased pericytes on the vasculature as compared with control tissue.CONCLUSIONS: Intravitreal injection of bevacizumab may induce changes in immature, newly formed vessels of PDR or NVG tissue, leading to endothelial apoptosis with vascular regression, while inducing normalization of premature vessels by increasing pericyte coverage and reducing vessel fenestration. (Am J Ophthalmol 2010;150:223-229. (C) 2010 by Elsevier Inc. All rights reserved.)