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Early effects of intravitreal triamcinolone acetonide on inflammation and proliferation in human choroidal neovascularization Tatar O; Adam A; Shinoda K; Kaiserling E; Boeyden V; Claes C; Eckardt C; Eckert T; Pertile G; Scharioth GB; Yoeruek E; Szurman P; Bartz-Schmidt KU; Grisanti SArch Ophthalmol 2009[Mar]; 127 (3): 275-81OBJECTIVE: To evaluate the early effects of triamcinolone acetonide (TA) on inflammation, proliferation, and vascular endothelial growth factor (VEGF) in human choroidal neovascularization (CNV). METHODS: Retrospective review of an interventional case series of 29 patients who underwent macular translocation. Fourteen CNV membranes without previous therapy (control CNV group) and 4 CNV membranes excised 3 days after photodynamic therapy (PDT CNV group) comprised the control groups. Eleven patients were treated with intravitreal TA (TA CNV group; n = 5) or PDT and TA combined (PDT+TA CNV group; n = 6) 3 to 9 days preoperatively. The CNV membranes were stained for cytokeratin 18, CD34, VEGF, intercellular adhesion molecule-1 (ICAM-1), E-selectin, CD68, CD45, Ki-67, and Thy-1. RESULTS: Treatment with TA and PDT+TA resulted in increased immunostaining of ICAM-1 in endothelial cells and the stroma and a higher percentage of Thy-1 expression than controls. The density of macrophages was significantly increased in PDT+TA CNV membranes. Leukocyte density and proliferative activity were lower in TA and PDT+TA CNV membranes. The total VEGF score was significantly increased in TA and PDT+TA CNV membranes compared with the control CNV membranes. Evidence of VEGF in the retinal pigment epithelium of PDT+TA CNV membranes was stronger than in control CNV membranes. CONCLUSIONS: Triamcinolone acetonide has no inhibitory effect on macrophage infiltration or ICAM-1, Thy-1, or VEGF expression in CNV membranes in the early term. The clinical benefits of TA are probably not based on pure antiinflammatory or VEGF-suppressing mechanisms.|*Lymphocyte Activation[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Anti-Inflammatory Agents/*therapeutic use[MESH]|Antigens, CD/metabolism[MESH]|Antigens, Differentiation, Myelomonocytic/metabolism[MESH]|Choroidal Neovascularization/*drug therapy/metabolism/pathology/surgery[MESH]|Combined Modality Therapy[MESH]|E-Selectin/metabolism[MESH]|Female[MESH]|Humans[MESH]|Immunoenzyme Techniques[MESH]|Inflammation/drug therapy/metabolism[MESH]|Injections[MESH]|Intercellular Adhesion Molecule-1/metabolism[MESH]|Laser Coagulation[MESH]|Leukocyte Common Antigens/metabolism[MESH]|Leukocyte Count[MESH]|Leukocytes/*pathology[MESH]|Macrophages/*pathology[MESH]|Macular Degeneration/surgery[MESH]|Male[MESH]|Middle Aged[MESH]|Photochemotherapy[MESH]|Retina/transplantation[MESH]|Retrospective Studies[MESH]|Thy-1 Antigens/metabolism[MESH]|Triamcinolone Acetonide/*therapeutic use[MESH]|Vascular Endothelial Growth Factor A/*metabolism[MESH]|Vitreous Body[MESH] |
