Preoperative Factors Influencing Visual Outcome following Surgical Excision of Subfoveal Choroidal Neovascularization in Age-Related Macular Degeneration

Shimada, Hiroyuki; Fujita, Kyoko; Matsumoto, Yōko; Mori, Ryusaburo; Yuzuwa, M

doi:10.1177/112067210601600215

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…In contrast, other previous studies have reported finding stabilization of the AMD and improvement of the visual acuity of the patients, especially in the cases with classic CNV, although a selection bias could not be definitively ruled out. 13 , 14 , 15 Based on these previous reports and the findings in the current case, we decided that the surgical removal of the CNV should be used as the following indications were found for the patient: 1) the CNV was of the classic type, 2) no additional retinal damage would be caused by retinotomy as the CNV removal was performed via the macular hole, 3) the procedure would lead to less risk of RPE damage during the CNV removal except at the site of the CNV, and 4) there would be less risk of bleeding during the CNV removal after the anti-VEGF therapy. Furthermore, because the half-life of the anti-VEGF agent is known to be shortened after vitrectomy, 16 stabilization of the AMD by CNV removal would help to reduce the number of the anti-VEGF treatments required.…”

Section: Discussionmentioning

confidence: 99%

Removal of choroidal neovascular membrane in a case of macular hole after anti-VEGF therapy for age-related macular degeneration

Hirata

Hayashi

Murata

et al. 2018

American Journal of Ophthalmology Case Reports

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PurposeThe formation of macular hole after receiving anti-vascular endothelial growth factor (anti-VEGF) therapy is rare. We report a case of macular hole that occurred after intravitreal injection of an anti-VEGF agent for age-related macular degeneration (AMD) in a patient, who underwent vitrectomy combined with choroidal neovascularization (CNV) removal.ObservationsA 64-year-old female with AMD affecting her right eye received an intravitreal injection of an anti-VEGF agent. After treatment, we identified a full thickness macular hole (MH) that was associated with the rapid resolution of the macular edema and contraction of the CNV. After performing vitrectomy combined with CNV removal, the MH closed and her visual acuity improved. Examination of the removed CNV revealed a network of microvessels devoid of pericytes.Conclusions and importanceThe present findings suggest that rapid resolution of macular edema and contraction of the CNV and/or mild increase in the vitreous traction after anti-VEGF therapy could potentially cause MH. CNV removal via the MH may be an acceptable procedure, if the MH remains open, the CNV is of the classic type, and it spares a central portion of the fovea.

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Section: Discussionmentioning

confidence: 99%

Removal of choroidal neovascular membrane in a case of macular hole after anti-VEGF therapy for age-related macular degeneration

Hirata

Hayashi

Murata

et al. 2018

American Journal of Ophthalmology Case Reports

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“…PVR pathogenesis is complex; however it is likely that, following trauma or retinal detachment, RPE cells migrate from their normal anatomic compartment, proliferate, dedifferentiate, undergo an epithelial to mesenchymal transformation (EMT), respond to many stimuli, and help create an intravitreal membrane (Al-Khairi et al, 2008; Asaria and Gregor, 2002; Campochiaro, 1997; Cardillo et al, 1997; Glaser et al, 1987; Kruger et al, 2002; Shimada et al, 2006). It is likely that the RPE cells produce membrane contraction that generates tractional force leading to retinal detachment (Hinton et al, 2002; Jin et al, 2000; Mukherjee and Guidry, 2007; Sakamoto et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

Anti-EMP2 diabody blocks epithelial membrane protein 2 (EMP2) and FAK mediated collagen gel contraction in ARPE-19 cells

Morales

Telander²,

Mareninov

et al. 2012

Experimental Eye Research

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Epithelial membrane protein 2 (EMP2) regulates collagen gel contraction by the retinal pigment epithelium cell line ARPE-19 by modulating FAK activation. Collagen gel contraction is one in vitro model for an aberrant wound healing response, proliferative vitreoretinopathy (PVR), which occurs as a complication of severe ocular trauma. The purpose of this study is to investigate whether EMP2 specific recombinant diabody decreases activation of FAK and collagen gel contraction in ARPE-19. Anti-EMP2 diabody was recombinantly constructed from a human phage library-derived clone selected for reactivity against an extracellular domain of human EMP2. ARPE-19 cells were exposed to an anti-EMP2 or control diabody, and toxicity, adhesion, and migration were assessed respectively through toluidine blue exclusion, binding to collagen type 1, and a migration assay. Collagen gel contraction was assessed using an in vitro assay. FAK activation was evaluated using Western blot. Exposure to anti-EMP2 diabody resulted in a 75% reduction in EMP2 protein levels at 4 hours. No significant toxicity was observed with anti-EMP2 diabody at levels that maximally reduced EMP2. Anti-EMP2 diabody, but not control diabody significantly reduced collagen gel contraction (p<0.001), and was not secondary to changes in adhesion or migration. Concordantly, anti-EMP2 diabody as compared to a control diabody reduced collagen stimulated FAK activation (p=0.01). Anti-EMP2 diabody decreases EMP2 protein levels, FAK activation, and collagen gel contraction by ARPE-19 cells without an adverse effect on cell survival. Modulation of EMP2 using anti-EMP2 diabody could be a new approach for targeting EMP2 and pathologic consequences associated with EMP2.

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Preoperative Factors Influencing Visual Outcome following Surgical Excision of Subfoveal Choroidal Neovascularization in Age-Related Macular Degeneration

Cited by 2 publications

References 21 publications

Removal of choroidal neovascular membrane in a case of macular hole after anti-VEGF therapy for age-related macular degeneration

Removal of choroidal neovascular membrane in a case of macular hole after anti-VEGF therapy for age-related macular degeneration

Anti-EMP2 diabody blocks epithelial membrane protein 2 (EMP2) and FAK mediated collagen gel contraction in ARPE-19 cells

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