March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Angiofibrotic Response To VEGF Inhibition In Membranes Extracted During Diabetic Vitrectomy: Results Of A Randomized, Controlled, Translational Study
Author Affiliations & Notes
  • Elliott H. Sohn
    Retina Service, University of Iowa Hospitals and Clinics, Iowa City, Iowa
  • Christine Spee
    Ophthalmology, Keck Sch of Med, Univ of So CA, Los Angeles, California
  • Shikun He
    Ophthalmology-USC, Doheny Eye Institute, Los Angeles, California
  • Dean Eliott
    Retina Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts
  • David R. Hinton
    Pathology, Keck School of Medicine USC, Los Angeles, California
  • Footnotes
    Commercial Relationships  Elliott H. Sohn, None; Christine Spee, None; Shikun He, None; Dean Eliott, Genentech (C); David R. Hinton, None
  • Footnotes
    Support  Research to Prevent Blindness. NEI Grant EY03040
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 360. doi:
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      Elliott H. Sohn, Christine Spee, Shikun He, Dean Eliott, David R. Hinton; Angiofibrotic Response To VEGF Inhibition In Membranes Extracted During Diabetic Vitrectomy: Results Of A Randomized, Controlled, Translational Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):360.

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      © ARVO (1962-2015); The Authors (2016-present)

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Connective tissue growth factor (CTGF) is a fibrosis inducer that is elevated in proliferative diabetic retinopathy. The goal of this study was to determine the expression of vascular endothelial growth factor (VEGF) and CTGF in membranes causing diabetic traction detachment with regard to vascular endothelial cells, myofibroblasts, and cytokeratin.


In a randomized, controlled, prospective trial ( NCT01270542) of 20 eyes (n=10 controls, n=10 given preoperative bevacizumab 3-7 days prior to diabetic traction detachment surgery), epiretinal membranes were excised at the time of vitrectomy. The membranes were snap frozen and sectioned at 9 µm. Sections were immunofluorescent stained with anti-CTGF or anti-VEGF antibody followed by antibody specific for endothelial cells (CD31), myofibroblasts (smooth muscle actin [SMA]), or cytokeratin. Volocity software (version 5.4) allowed quantitative and co-localization analysis of antibody content obtained through immunofluorescence confocal microscopy. Multiple sections for each membrane were averaged for each eye.


The bevacizumab group had a greater than 25% reduction in co-localization in the CD31-CTGF and cytokeratin-CTGF studies compared to controls. There was no change in VEGF colocalization between the treated and controls. See figure for complete results.


Intravitreal bevacizumab 1.25 mg administered within one week of surgery may decrease VEGF and CTGF expression in diabetic traction membranes. VEGF inhibition decreases co-expression of CTGF but not VEGF in vascular endothelial cell and cytokeratin stains. Attenuation of fibrovascular activity in membranes might provide scientific rationale for performing surgery within 7 days of preoperative adjunctive bevacizumab for diabetic traction detachment.  

Clinical Trial: NCT01270542

Keywords: diabetic retinopathy • retinal detachment • cytokines/chemokines 

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