The Histopathologic Observation For Diabetic Retinopathy Membrane After Use Anti-VEGF Gene

Objective:To analyze the histopathologic change of proliferative membrane in patient with diabetic retinopathy after intravitreal injection of anti-VEGF factor (Avastin).To determine the expression of vascular endothelia growth factor (VEGF), connective tissue growth factor(CTGF) and pigment epitheliumderived factor(PEDF) in proliferative membrane.Methods:The 24 patients (26 eyes) with diabetic retinopathy between January 2008 and June were divided into 2 groups randomly. Control groups received vitrectomy directly, but experimental groups received vitrectomy 10 days after intravitreal injection of anti-VEGF (Avastin). During surgery the proliferative membrane were peeled, and by HE staining method to observe the change of its new vessels, vascular endothelial cell, initial cell. Immunohistochemistry were used to assess the expression of VEGF, CTGF and PEDF.Results:The diabetic retinopathy proliferative membrane are made up of extracellular matrix, different morphology cell and new vessels under light microscope. The difference of new vessels,vascular endothelial cell, initial cell was statistical significant between the two groups (P<0.05).The expression of VEGF:In experimental groups, the positive rate of VEGF were decreased. The rate of positive were statistically significant difference between two groups (P<0.05).The expression of CTGF:around the new vessels, particularly the immature vessels.In experimental groups, the positive rate of CTGF were increased.The expression of positive was statistically significant difference between two groups (P <0.05).The expression of PEDF could be detected in the cytoplasm, nucleus and collagen matrix.In experimental groups, the positive rate of PEDF were increased,but no statistical difference between two groups (P>0.05).Conclusion:Intravitreal anti-VEGF factor is associated with a rapid regression of retinal neovascularization secondary to diabetic retinopathy, reduce hemorrhage. The proliferative membrane in patient with diabetic retinopathy after intravitreal injection of anti-VEGF factor is increased, and CTGF expression were higher in retinopathy proliferative membrane; but PEDF expression were no obvious change.