Br J Ophthalmol 1999;83:838-846 ( July )
Angiogenic factors in human proliferative sickle cell retinopathy
Jingtai Caoa, Michaela Kunz Mathewsa, D Scott McLeoda, Carol Mergesa, Leonard M Hjelmelandb, Gerard A Luttya
a Wilmer
Ophthalmological Institute, Johns Hopkins University School of
Medicine, Baltimore, MD, USA, b School of Medicine, University of California at
Davis, Davis, CA, USA
Correspondence to: Gerard A Lutty, PhD, 170 Woods Research Building, Wilmer
Ophthalmological Institute, Johns Hopkins Hospital, 600 North Wolfe
Street, Baltimore, MD 21287-9115, USA.
Accepted for publication 14 January 1999
BACKGROUND/AIMS Preretinal
neovascular formations called sea fans develop at the border of
non-perfused peripheral retina in sickle cell retinopathy. Angiogenic factors which could contribute to their development, however, have not been examined previously. The objective of this study
was to determine immunohistochemically if vascular endothelial growth
factor (VEGF) or basic fibroblast growth factor (bFGF) were associated
with sea fan formations.
METHODS Immunohistochemistry
on cryosections was used to localise bFGF, VEGF, heparan sulphate
proteoglycan, human serum albumin, collagens IV and II, and von
Willebrand factor in tissue from five sickle cell and one control subject.
RESULTS The greatest
immunoreactivity for VEGF and bFGF was in the feeder and preretinal
vessels of sea fans (p<0.01). The most prominent reaction product was
localised to vascular endothelial cells. In retinal vessels, VEGF and
bFGF immunoreactivities were greater in sickle cell subjects (both
proliferative and non-proliferative) than in the control subject
(p<0.01 and p<0.02 respectively). In the sickle cell retina, no
angiogenic factor immunoreactivity was detected in non-perfused
periphery and there was no significant difference in bFGF or VEGF
immunoreactivity between perfused retina and the border of perfused and
non-perfused areas.
CONCLUSION Our results
demonstrate for the first time that VEGF and bFGF are associated with
sea fan formations in sickle cell retinopathy. Both factors may
function in an autocrine manner because immunoreactivity for these
factors was greater within the neovascularisation than in adjacent retina.
© 1999 by British Journal of Ophthalmology
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