Effects of vitreous from photocoagulated eyes on retinal microvascular cells in culture: a preliminary report

Role of vascular endothelial growth factor in the breakdown of the blood-aqueous barrier after retinal laser photocoagulation in pigmented rabbits

PURPOSE

Retinal laser photocoagulation is used to treat a variety of retinal diseases. Breakdown of the blood-aqueous barrier has been noted after retinal laser photocoagulation. The effect of vascular endothelial growth factor (VEGF) on the function of the blood-aqueous barrier after retinal laser photocoagulation remains undetermined. The current study was designed to evaluate the relationship between intraocular levels of VEGF and breakdown of the blood-aqueous barrier after retinal laser photocoagulation in rabbits.

METHODS

Pigmented rabbits were treated with retinal laser photocoagulation in one eye; the other served as control. Laser flare photometry was carried out on post-treatment days 1, 3, 7, and 14. Animals were sacrificed at the time period just mentioned postlaser, the eyes were removed, and samples of vitreous and aqueous humor were collected. Intraocular VEGF levels were measured by using an immunoassay. An intravitreal injection of VEGF was administered, and the aqueous flare intensity and VEGF levels in the aqueous and vitreous humor were measured at the time periods just mentioned.

RESULTS

A significant increase in the aqueous flare intensity after retinal laser photocoagulation was noticed on postoperative day 1, with the values returning to baseline levels on day 14. The VEGF levels in the vitreous of the lasered eyes were significantly increased on day 1 compared with the nonlasered control eyes. The VEGF levels in the aqueous humor of the lasered eyes were also significantly increased on day 1 compared with the control eyes. An intravitreal injection of VEGF induced a significant increase in the aqueous flare intensity and VEGF levels in the aqueous and vitreous humor.

CONCLUSIONS

The current results suggested that retinal laser photocoagulation can produce a breakdown of the blood-aqueous barrier. VEGF may play a role in the blood-aqueous barrier dysfunction after retinal laser photocoagulation.

Immunocytochemical study of retinal diode laser photocoagulation in the rat

AIM

To determine the nature of the cellular infiltrate, alterations in cell adhesion molecules, and MHC II antigen expression in the rat retina following diode laser retinal photocoagulation.

METHOD

20 normal Lister rats underwent diode laser photocoagulation of the retina. Frozen sections from eyes enucleated at 0, 1, 5, 13, and 33 days post laser were examined for T cells (R7.3), CD4 T cells (W3/25), activated CD4 T cells (OX-40), CD8 T cells (OX-8), B cells (OX-33), and macrophages (OX-42), MHC II antigen (OX-6), and E-Selectin-1, VCAM-1, and ICAM-1.

RESULTS

Retinal diode laser photocoagulation stimulated a wound healing response in the outer retina and choroid. The cellular infiltrate included macrophages and activated CD4 T cells at 13 and 33 days post laser. Glial cells in the inner plexiform and inner nuclear layers expressed MHC II antigen at 24 hours only. ICAM-1 antigen was induced in RPE cells and in Muller cells in the inner retina at all time intervals post laser and intense staining for ICAM-1 was present around intraretinal migrated cells at 13 and 33 days post laser. VCAM-1 antigen expression was induced in the choroidal vascular endothelium and RPE at 13 and 33 days after laser as was E-Selectin-1 antigen expression which was also evident focally at the external limiting membrane in association with migrated cells adjacent to the burn.

CONCLUSIONS

These results suggest that alterations in cell adhesion molecules may regulate the migration and activation of retinal pigment epithelium, macrophages and CD4 T cells at the outer blood-retinal barrier and choroid following diode laser photocoagulation of the normal Lister rat retina.

The effect of scatter laser photocoagulation on intravitreal levels of growth factors in the miniature pig

PURPOSE

To characterise changes in intravitreal growth factor profiles following retinal photocoagulation in the miniature pig.

METHODS

Miniature pig eyes underwent scatter photocoagulation by either diode infrared or emerald green laser. Animals were sacrificed at various times (up to 42 days) post-laser. The eyes were than removed and vitreous samples analysed for basic fibroblast growth factor, insulin-like growth factor-I and epidermal growth factor by radioimmunoassay, transforming growth factor-beta 2 by ELISA and insulin-like growth factor binding proteins using Western ligand blotting.

RESULTS

Vitreous transforming growth factor-beta 2 levels were decreased at 1 h post diode laser and at 4 and 7 days post emerald laser but returned to normal by 21 and 42 days respectively. Vitreous insulin-like growth factor-I levels increased at 4 and 7 days post diode and emerald laser respectively but returned to normal by 21 days. Insulin-like growth factor Western ligand blotting demonstrated that a 34 kDa insulin-like growth factor binding protein was predominant in the pig vitreous; the levels of this binding protein followed an identical trend to those observed for insulin-like growth factor-I. No changes in vitreous levels of either basic fibroblast growth factor or epidermal growth factor were observed following laser treatment.

CONCLUSIONS

Our results demonstrate a significant shift in the balance of intravitreal growth factors following retinal laser photocoagulation. Such changes may be pertinent to the regression of preretinal new vessels after laser photocoagulation.

Immunohistochemical localization of transforming growth factor-beta in human photoreceptors

Transforming growth factor-beta (TGF-beta) is a multifunctional growth factor that can either stimulate or inhibit cellular proliferation depending on cell type and culture conditions. The immunohistochemical localization of TGF-beta was investigated in human retinas and choroids using streptavidin peroxidase immunohistochemistry and a polyclonal rabbit antibody directed against the N-terminal 30 amino acids of TGF-beta 1. This antibody recognizes the beta 1 form of TGF-beta but not beta 2. TGF-beta localization was observed exclusively in photoreceptors in all adult non-diabetic and non-insulin dependent diabetic eyes, and 4 of 6 insulin dependent eyes. It was determined that TGF-beta was associated with both rods and cones using localization of peanut agglutinin (PNA), a lectin which binds to cone sheaths, on serial sections. Chondroitinase ABC digestion of sections prior to immunohistochemistry did not reduce TGF-beta immunoreactivity, suggesting that binding was not to glycosaminoglycans in the interphotoreceptor matrix. TGF-beta immunoreactivity was not observed in 2 premature human eyes in which photoreceptor outer segments had not yet developed. Localization in photoreceptors was also not observed in photocoagulation scars, in atrophic regions in a diabetic retina, nor in detached areas of retina from a young victim of head trauma. Based on PNA binding, succinate dehydrogenase enzyme histochemistry and phase contrast microscopy on adjacent sections, the TGF-beta negative areas of these retinas did not appear to have viable photoreceptors. This work demonstrates that TGF-beta is found exclusively in viable adult human retinal photoreceptors. It's function in these cells is currently not known.

Inhibition of microvascular endothelial cell proliferation by vitreous following retinal scatter photocoagulation

Laser photocoagulation of pig retina induced breakdown of the blood-retinal barrier, with the appearance of serum proteins in the vitreous as determined by sodium dodecyl sulphate/polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting techniques. Vitreous from lasered eyes inhibited the proliferation of cultured retinal microvascular endothelial cells in comparison with vitreous from non-lasered control eyes, and the inhibitory effect in the lasered eyes persisted for at least seven days. Inhibition was specific for endothelial cells, since no effect was observed when retinal pericytes or Tenon's fibroblasts were the target cells. These results suggest that indirect scatter photocoagulation may induce regression of neovascularisation by causing breakdown of the blood-retinal barrier and thus releasing into the vitreous serum components which result in inhibition of retinal microvascular endothelial cell growth.

Abortive neovascular outgrowths discovered during vitrectomy for diabetic vitreous haemorrhage

Abortive neovascular outgrowths from the retina were identified in 13 out of 34 eyes (38%) undergoing vitrectomy for diabetic vitreous haemorrhage. Postoperatively, fluorescein angiography of the lesions demonstrated a characteristic "smoke-stack" pattern of dye leakage. Each outgrowth appears to represent a focal variant of preretinal neovascularisation complicating retinal capillary non-perfusion and inner retinal ischaemia, their distinctive features being determined primarily by the absence of a cortical vitreous scaffold on the retinal surface at the time of vasoproliferation.