脈絡膜新生血管に対する光凝固の血管新生因子に及ぼす影響

Effect of laser photocoagulation on angiogenetic factorsin choroidal neovascularization

　目的：光凝固後に再発して摘出した脈絡膜新生血管（choroidal neovascularization：CNV）組織について光凝固部位と再発部位を比較し，光凝固の作用を検討すること。

　症例と方法：症例は特発性CNVの48歳女性と加齢黄斑変性の71歳男性。摘出したCNV組織を免疫組織化学的に検索した。

　結果：両症例とも，再発部位には著しい新生血管があり，光凝固部位には内皮細胞がほとんどなかった。再発部位には血管内皮増殖因子（vascular endothelial growth factor：VEGF），アンジオポイエチン—2（angiopoietin2：Ang2）などの増殖因子の強い発現があり，光凝固部位では発現が低下していた。

　結論：光凝固はVEGFやAng2の発現を抑制し，新生血管形成を抑える可能性がある。

Purpose: To evaluate the effect of photocoagulation followed by recurrence of choroidal neovascularization (CNV) in excised specimens.

Cases and Method: Tissues were surgically removed from a 48-year-old female with idiopathic CNV and a 71-year-old male with age-related macular degeneration. The tissues were subjected to immunohistological studies.

Findings: In both specimens, the sites of recurrence showed profuse neovascularization. The photocoagulated sites almost lacked endothelial cells. The sites of recurrence showed enhanced activity of vasoformative factors including vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang 2) . The photocoagulated sites showed decreased activity of vasoformative factors.

Conclusion: Photocoagulation suppresses VEGF and Ang 2 and would inhibit neovascularization.