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Article: Fibrous membranes in diabetic retinopathy and bevacizumab

TitleFibrous membranes in diabetic retinopathy and bevacizumab
Authors
Issue Date2010
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.retinajournal.com
Citation
Retina, 2010, v. 30 n. 7, p. 1012-1016 How to Cite?
AbstractPurpose: The purpose of this study was to determine the histopathologic characteristics of bevacizumab-treated human proliferative diabetic retinopathy (PDR) membranes with particular regard to membrane vasculature as a step toward addressing the effects of the drug on PDR membranes. Intravitreous injection of bevacizumab, an antivascular endothelial growth factor monoclonal antibody, has recently been advocated as an adjunct in surgery for PDR. In this context, a clinically observed decrease in PDR epiretinal membrane vascularity (vascular regression) occurs from 24 hours to 48 hours after injection, but the exact mechanisms of drug action are unknown. Methods: A consecutive series of seven PDR membrane specimens that had been removed sequentially from seven bevacizumab-treated patients were studied retrospectively. The membrane specimens were examined using light microscopic methods, including immunohistochemistry. Results: Five of the seven membranes were clinically avascular (one contained "ghost" vessels) and did not hemorrhage during excision. Of these 5 specimens, which included 1 removed 7 days after a total of 6 intravitreous injections of 1.25 mg bevacizumab, 4 contained histologically detectable capillaries (1 did not). These blood vessels were lined by endothelial cells as determined by immunohistochemistry for the endothelial markers CD31 and CD34. The two remaining membranes were clinically and histologically still vascularized despite bevacizumab treatment. All the specimens also contained smooth muscle actin-containing fibroblastic cells within the collagenous stroma. Conclusion: The findings do not support the concept that the clinical phenomenon of vascular regression in PDR membranes after bevacizumab injection in the vitreous is resulting from obliteration of the membrane blood vessels. Another mechanism appears to be involved in at least some patients, possibly a vasoconstrictive response. Such a mechanism might explain reversal of the effects of bevacizumab that has been reported after this treatment. © The Ophthalmic Communications Society, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/127678
ISSN
2015 Impact Factor: 3.039
2015 SCImago Journal Rankings: 1.912
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorPattwell, DMen_HK
dc.contributor.authorStappler, Ten_HK
dc.contributor.authorSheridan, Cen_HK
dc.contributor.authorHeimann, Hen_HK
dc.contributor.authorGibran, SKen_HK
dc.contributor.authorWong, Den_HK
dc.contributor.authorHiscott, Pen_HK
dc.date.accessioned2010-10-31T13:39:41Z-
dc.date.available2010-10-31T13:39:41Z-
dc.date.issued2010en_HK
dc.identifier.citationRetina, 2010, v. 30 n. 7, p. 1012-1016en_HK
dc.identifier.issn0275-004Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/127678-
dc.description.abstractPurpose: The purpose of this study was to determine the histopathologic characteristics of bevacizumab-treated human proliferative diabetic retinopathy (PDR) membranes with particular regard to membrane vasculature as a step toward addressing the effects of the drug on PDR membranes. Intravitreous injection of bevacizumab, an antivascular endothelial growth factor monoclonal antibody, has recently been advocated as an adjunct in surgery for PDR. In this context, a clinically observed decrease in PDR epiretinal membrane vascularity (vascular regression) occurs from 24 hours to 48 hours after injection, but the exact mechanisms of drug action are unknown. Methods: A consecutive series of seven PDR membrane specimens that had been removed sequentially from seven bevacizumab-treated patients were studied retrospectively. The membrane specimens were examined using light microscopic methods, including immunohistochemistry. Results: Five of the seven membranes were clinically avascular (one contained "ghost" vessels) and did not hemorrhage during excision. Of these 5 specimens, which included 1 removed 7 days after a total of 6 intravitreous injections of 1.25 mg bevacizumab, 4 contained histologically detectable capillaries (1 did not). These blood vessels were lined by endothelial cells as determined by immunohistochemistry for the endothelial markers CD31 and CD34. The two remaining membranes were clinically and histologically still vascularized despite bevacizumab treatment. All the specimens also contained smooth muscle actin-containing fibroblastic cells within the collagenous stroma. Conclusion: The findings do not support the concept that the clinical phenomenon of vascular regression in PDR membranes after bevacizumab injection in the vitreous is resulting from obliteration of the membrane blood vessels. Another mechanism appears to be involved in at least some patients, possibly a vasoconstrictive response. Such a mechanism might explain reversal of the effects of bevacizumab that has been reported after this treatment. © The Ophthalmic Communications Society, Inc.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.retinajournal.comen_HK
dc.relation.ispartofRetinaen_HK
dc.subject.meshAngiogenesis Inhibitors - administration and dosage-
dc.subject.meshAntibodies, Monoclonal - administration and dosage-
dc.subject.meshBasement Membrane - blood supply - pathology-
dc.subject.meshDiabetic Retinopathy - drug therapy - metabolism - pathology-
dc.subject.meshRetinal Neovascularization - drug therapy - metabolism - pathology-
dc.titleFibrous membranes in diabetic retinopathy and bevacizumaben_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0275-004X&volume=30&issue=7&spage=1012&epage=1016&date=2010&atitle=Fibrous+membranes+in+diabetic+retinopathy+and+bevacizumab-
dc.identifier.emailWong, D: shdwong@hku.hken_HK
dc.identifier.authorityWong, D=rp00516en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/IAE.0b013e3181cb463aen_HK
dc.identifier.pmid20616680-
dc.identifier.scopuseid_2-s2.0-77954730897en_HK
dc.identifier.hkuros181866en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77954730897&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume30en_HK
dc.identifier.issue7en_HK
dc.identifier.spage1012en_HK
dc.identifier.epage1016en_HK
dc.identifier.isiWOS:000279635600003-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridPattwell, DM=6505863976en_HK
dc.identifier.scopusauthoridStappler, T=8563727800en_HK
dc.identifier.scopusauthoridSheridan, C=7004974390en_HK
dc.identifier.scopusauthoridHeimann, H=7006780277en_HK
dc.identifier.scopusauthoridGibran, SK=13205333800en_HK
dc.identifier.scopusauthoridWong, D=7401536078en_HK
dc.identifier.scopusauthoridHiscott, P=7006368693en_HK

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