ABSTRACT
A more complete understanding of the role of apoptosis in the regression of diabetic neovasculature following laser panretinal photocoagulation (PRP) will both elucidate the treatment's therapeutic mechanism and potentially lead to novel treatments for neovascularization associated with proliferative diabetic retinopathy that target apoptotic pathways. Pars plana vitrectomy with fibrovascular membrane delamination was performed on five patients with proliferative diabetic retinopathy, with four having received previous PRP treatment and one no previous laser treatment. Using in situ terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling, propidium iodide and hematoxylin-eosin staining, apoptotic cells were identified in the excised membranes. The authors found evidence of cells undergoing apoptosis in all of the excised membranes, with increasing amounts of preoperative PRP associated with an increased number of apoptotic cells per millimeter of membrane. The preliminary data suggest that the decrease in ambient mitogen, initiated by PRP treatment, activates apoptosis in diabetic fibrovascular membranes.
AUTHORS
From University of Massachusetts Medical School (ATT, JS), Department of Ophthalmology; Massachusetts Eye & Ear Infirmary (DVB, JGA); and Beth Israel Deaconess Medical Center (KDK, JGA), Harvard Medical School, Boston, Massachusetts.
Originally submitted June 12, 2009. Accepted for publication March 19, 2010. Posted online June 30, 2010.
Dr. Arroyo is a recipient of a K-23 Physician Training Award. This study was supported by funds from the Beth Israel Deaconess Medical Center Retina Service Research Fund.
The authors have no financial or proprietary interest in the materials presented herein.
Address correspondence to Jorge G. Arroyo, MD, MPH, Retina Service, Director, Division of Ophthalmology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Shapiro 5th Floor, Boston, MA 02215.
doi: 10.3928/15428877-20100625-06
