Differences in retinal neovascular tissue and vitreous humour in patients with type 1 and type 2 diabetes

Br J Ophthalmol. 2009 Aug;93(8):1109-15. doi: 10.1136/bjo.2008.148841. Epub 2009 Mar 19.

Abstract

Aims: The aim of the study was to evaluate the histopathology of neovascular tufts and vitreous samples collected from patients with diabetes.

Methods: Vitreous samples and neovascular tufts were collected from patients with type 1 (n = 13) and (n = 17) type 2 diabetes with proliferative retinopathy, and from controls with a macular hole (n = 5). Neovessels were analysed using immunohistochemistry and vitreous samples with an enzyme-linked immunosorbent assay (ELISA). The main outcome measure was to examine differences in the levels of growth factors in patients with type 1 and type 2 diabetes with proliferative retinopathy.

Results: Vascular endothelial growth factor (VEGF)-A was most strongly present in the samples from patients with type 1 diabetes. In type 2 diabetes, VEGF-D was more abundantly present than in type 1 diabetes. Angiopoietin (ANG)-2 was also abundantly present. Macrophages and nuclear factor kappa B (NFkappaB) were found, indicating the presence of an inflammatory process in the neovascular tissues.

Conclusions: VEGF-A and ANG-2 are equally important in the neovascular process in both type 1 and type 2 diabetes. VEGF-D is abundantly present in type 2 diabetes. In order to achieve better control of diabetic retinopathy, it might be beneficial to develop treatments that prevent the actions of ANG-2 and VEGF-D.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Angiogenesis Inducing Agents / metabolism*
  • Angiopoietin-1 / metabolism
  • Angiopoietin-2 / metabolism
  • Diabetes Mellitus, Type 1 / metabolism*
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 2 / metabolism*
  • Diabetes Mellitus, Type 2 / pathology
  • Diabetic Retinopathy / metabolism*
  • Diabetic Retinopathy / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retinal Neovascularization / metabolism*
  • Vascular Endothelial Growth Factor A / metabolism
  • Vascular Endothelial Growth Factor D / metabolism
  • Vitreous Body / metabolism

Substances

  • ANGPT1 protein, human
  • Angiogenesis Inducing Agents
  • Angiopoietin-1
  • Angiopoietin-2
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Vascular Endothelial Growth Factor D