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E Yamada, H Yamada, Y Yamazaki, M Matsumura; Inhibitory Effect of Angiotensin Converting Enzyme Inhibitors on Choroidal Neovascularization . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1271.
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Purpose: Angiotensin Converting Enzyme Inhibitor (ACE-I) is used all over the world to control hypertension. Its clinical advantage is that it not only reduces blood pressure but also improves the prognosis of patients after cardiac or cerebral infarction by a vascular remodeling effect. There have been several reports on the anti-neovascular effects of ACE-I. We studied the efficacy of ACE-I on retinal neovascularization (NV). Methods: To induce experimental CNV, adult C57bl mice were anesthetized and 4 spots per eye were exposed to an intense Krypton laser in order to break Bruch's membrane. After the laser treatment, we administrated 30 mg/kg Atenolol (b blocker), 20 mg/kg Enalapril (ACE-I), 2 mg/ml Perindopril (ACE-I), 20 mg/kg Perindopril, or [Author: correct?] vehicle only (dH2O) once a day for 14 days. On day 14, the eyes were enucleated and fixed in formalin for 1 hour. The anterior segment, lens, and retina were removed under a dissection microscope,. We flat-mounted the posterior portion with the choroidal side up and observed it under a fluorescence microscope. Each of the laser lesions was photographed and scanned into a computer. Using ImagePro Software, areas of CNV were encircled and evaluated. The average size of four CNV in each eye was used as one experimental value. Results: Mice administered Atenolol, Enalapril, 2 mg/ml Perindopril and vehicle only showed no statistical difference in the size of CNV. In contrast, 20 mg/kg Perindopril inhibited CNV by 45% compared to vehicle only (p=0.004). Conclusion: ACE-I suppressed laser-induced CNV only in a selected condition. Our unpublished data show that ACE-I inhibits retinal neovascularization by improving retinal ischemia and by a direct inhibitory effect. ACE-I seemed to have a lower efficacy in preventing neovascularization in the choroid than in retinal neovascularization. This may be because, although ischemia is the most important motivator in hypoxic retinopathy, it is not as important in CNV.
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