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O. Tatar, S. Grisanti, F. Gelisken, W. Inhoffen, P. Szurman, S. Aisenbrey, K.U. Bartz–Schmidt; Immunohistopathologic Evaluation Of Choroidal Neovascular Membranes Following Verteporfin–photodynamic Therapy . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1781.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the vascularization and proliferative activity in choroidal neovascular membranes (CNVM) due to age related macular degeneration (ARMD) after verteporfin photodynamic therapy (PDT) and submacular removal. Methods: Retrospective review of seven patients who underwent removal of subfoveal classic CNVM (n=7) after having been treated with PDT 3 to 146 days previously. CNVM were stained for CD 34, CD 105, and Ki–67 and were correlated with clinics and fluorescein angiography (FA). Results: FA performed on the day of surgery disclosed non–perfusion of the treated area 3 days after PDT, but perfusion and leakage were seen at greater post–PDT intervals. CNVM excised 3 days after PDT showed CD34 and CD105 positive, mostly occluded vessels. The endothelial cells appeared damaged. Ki–67 activity was low. In CNVM excised 34 to 146 days after PDT, all vessels appeared patent and were lined by healthy endothelial cells with strong expression of CD34, CD105. Ki–67 expression was elevated especially in the CNVM extracted after 34 days. Conclusion: PDT did not cause a general and complete occlusion of the vessels within the CNVM as suggested by FA three days after, but the endothelial cells appeared to be severely damaged. Proliferative activity within these specimens was clearly reduced. At longer intervals after PDT, the fibrovascular tissue seemed to recover and perfusion, hyperfluorescence and leakage of the CNVM could be detected by FA. The clinical appearance showed a correlation with the immunohistological characteristics of an increased proliferative activity and patent vascularization.
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