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Inhibition of vascular endothelial growth factor reduces scar formation after glaucoma filtration surgery
Author(s) -
VAN BERGEN T,
VAN DE VEIRE S,
MOONS L,
STALMANS I
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.5355.x
Subject(s) - trabeculectomy , medicine , bevacizumab , vascular endothelial growth factor , glaucoma , fibrosis , in vivo , fibroblast , glaucoma surgery , intraocular pressure , bleb (medicine) , basic fibroblast growth factor , ophthalmology , pharmacology , growth factor , pathology , in vitro , surgery , cancer research , chemistry , chemotherapy , biology , receptor , vegf receptors , biochemistry , microbiology and biotechnology
Purpose In 30‐50%, glaucoma filtration surgery fails due to excessive postoperative scarring. This study was designed to elucidate the role of vascular endothelial growth factor (VEGF) in fibrosis after glaucoma surgery. In addition, the effects of the monoclonal humanized VEGF‐antibody bevacizumab (AvastinTM, Genentech) on fibroblast proliferation and outcome after trabeculectomy were studied. Methods The effect of VEGF and bevacizumab on Tenon fibroblasts in vitro was determined using a Tenon fibroblast mediated proliferation assay. The effect of the antibody was also investigated in vivo in a rabbit model for glaucoma surgery by measuring intra‐ocular pressure (IOP) and bleb area, and by (immuno‐)histological analysis of inflammation and fibrosis. VEGF‐concentration after bevacizumab‐administration was measured in samples of aqueous humor by ELISA. Results The proliferation of human and rabbit Tenon fibroblasts in vitro was stimulated by VEGF‐delivery and inhibited by bevacizumab‐administration. The antibody also significantly improved glaucoma surgery outcome, more specific the bleb area, in a rabbit model of trabeculectomy. Inflammation and collagen deposition were significantly reduced after bevacizumab treatment as compared to sham injections. VEGF was significantly reduced in aqueous humor after bevacizumab‐administration. Conclusion VEGF stimulates in vitro fibroblast proliferation suggesting that it plays a role in scarring after filtering surgery. Furthermore, the monoclonal humanized VEGF‐antibody reduces in vitro fibroblast proliferation and improves surgical outcome in vivo in a rabbit model of trabeculectomy.