Paskowitz Daniel M, Nune George, Yasumura Douglas, Yang Haidong, Bhisitkul Robert B, Sharma Shivani, Matthes Michael T, Zarbin Marco A, Lavail Matthew M, Duncan Jacque L
Department of Ophthalmology, University of California, San Francisco, 94143-0730, USA.
Invest Ophthalmol Vis Sci. 2004 Nov;45(11):4190-6. doi: 10.1167/iovs.04-0676.
Verteporfin photodynamic therapy (PDT) is the most effective treatment for age-related macular degeneration, using laser activation of a photosensitizing dye to achieve closure of choroidal neovascularization. Although PDT preferentially affects pathologic vessels, it can also cause collateral damage to the overlying retina. In the current study, it was found that the neuroprotective agent brain-derived neurotrophic factor (BDNF) reduces this retinal damage.
Normal adult rats received intravitreal BDNF in one eye and PBS or no injection in the other eye 2 days before PDT.
Control eyes exhibited choroidal hypofluorescence, moderate to severe photoreceptor loss, and depression of local retinal function measured using multifocal ERG in the laser-treated area. BDNF-injected eyes had more surviving photoreceptors and improved multifocal ERG responses 1 week after PDT. BDNF did not diminish the effect of PDT on the choroidal circulation as assessed by fluorescein angiography, and there was no evidence of retinal toxicity due to BDNF treatment.
These results suggest that adjunctive neuroprotective therapy may reduce collateral damage to photoreceptors and improve visual outcome after PDT.
维替泊芬光动力疗法(PDT)是治疗年龄相关性黄斑变性最有效的方法,通过激光激活光敏染料来实现脉络膜新生血管的闭合。尽管PDT优先作用于病变血管,但它也会对覆盖其上的视网膜造成附带损伤。在当前研究中,发现神经保护剂脑源性神经营养因子(BDNF)可减少这种视网膜损伤。
正常成年大鼠在PDT前2天,一只眼睛玻璃体内注射BDNF,另一只眼睛注射磷酸盐缓冲液(PBS)或不注射。
对照眼表现出脉络膜低荧光、中度至重度光感受器丧失,以及在激光治疗区域使用多焦视网膜电图测量的局部视网膜功能减退。在PDT后1周,注射BDNF的眼睛有更多存活的光感受器,多焦视网膜电图反应得到改善。通过荧光素血管造影评估,BDNF并未减弱PDT对脉络膜循环的作用,并且没有证据表明BDNF治疗会导致视网膜毒性。
这些结果表明,辅助性神经保护疗法可能会减少对光感受器的附带损伤,并改善PDT后的视觉效果。