Molecular Mechanism and i Therapy for Choroidal Neovascularization

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Angiogenesis is believed to be controlled by a balance of stimulators such as vascular endothelial growth factor(VEGF), or inhibitors such as pigment epithelium-derived factor(PEDF).We found that the level of PEDF was lower and the level of VEGF was high in the vitreous of eyes with diabetic retinopathy, These results indicate that there is an upset balance of angiogenic stimulators and inhibitors in eye with diabetic retinopathy. In addition, the level of PEDF was lower in eyes with proliferative vitreoretinopathy. and high in eyes with rhegmatogenous retinal detachment, which indicates that PEDF is also controlling ocular cell proliferation.During the development of experimental choroidal neovascularization, VEGF and also PEDF were strongly detected in vascular endothelial cells, then gradually declined and PEDF was expressed in the RPE cells. These findings suggest that PEDF and VEGF may modulate the process of choroidal neovascularization.In human eyes, PEDF and VEGF were strongly expressed in the vascular endothelial cells and retinal pigment epithelial(RPE) cells in active choroidal neovascular membranes(CNVMs) and polypoidal choroidal vasculopathy, whereas PEDF and VEGF, were both weak in quiescent CNVMs. Our results suggest that PEDF along with VEGF may modulate the formation of subfoveal fibrovascular membranes.The PEDF levels decreased with increasing age. The negative correlation of PEDF level and age should be considered in age-related eye diseases especially those associated with angiogenesis.he mean levels of PEDF in eyes with retinitis pigmentosa and advanced glaucoma were significantly lower than that in eyes with cataract alone. The lower levels of PEDF in eyes with neuroretinal dystrophy may be related to the loss of the retinal ganglion cells and/or RPE cells that synthesize PEDF.