Posters

Influence of vascular endothelial growth factor and its soluble receptors on corneal neovascularization and graft survival rate in human corneas

Poster Details

First Author: M.Pauk Guli? CROATIA

Co Author(s): T. Balog   M. Merlak   S. Sobo?anec   N. Dra?a   N. Gabri?   I. Dekaris     

Abstract Details

Purpose:

Corneal neovascularization (NV) and inflammation is considered to be the main risk factor for a low graft success rate in high-risk patients after penetrating keratoplasty (PK) and vascular endothelial growth factor (VEGF) was recognized as main proangiogenic cytokine stimulating NV in different corneal diseases. Purpose of the study was to evaluate the quantity and correlation of VEGFA and VEGFC and its soluble receptors:sVEGFR1, sVEGFR2 and sVEGFR3 in the recipient cornea at the time of PK and its potential influence on graft rejection.

Setting:

Special Eye Hospital „Svjetlost“, Department of Ophthalmology, University of Rijeka, Zagreb; Croatia Rudjer Boskovic Institute; Zagreb, Croatia;

Methods:

Study included 60 eyes distributed by corneal pathology and degree of neovascularization into: low (N=20), medium (N=20), high (N=20) and 4th- control group (N=20). VEGFA and VEGFC, sVEGFR1, sVEGFR2 and sVEGFR3 were analyzed in corneal epithelium, stroma and endothelium and calculated in those 3 layers together, using an enzyme-linked immunosorbent assay (ELISA), correlated and compared with degree of corneal neovascularization and frequency of graft reaction. Statistical analysis was done by Kruskal-Wallis ANOVA non parametric test and difference between groups was analyzed by Mann-Whitney U-test or T test depending on the data distribution.

Results:

Highest concentration of VEGFA in total cornea was in high risk cases (599 pg/ml) and the lowest in controls(102 pg/ml).VEGFC showed trend similar to VEGFA but with statistical difference mainly in endothelium and total cornea(p=0,0387;p=0,0354 respectively).Soluble VEGFR1 and sVEGFR3 were significantly higher in low risk patients as compared to high risk group in total cornea. Soluble VEGFR2 followed the trendline, but without statistical difference among the groups.Eyes with graft reaction had significantly higher VEGFA and VEGFC and significantly lower sVEGFR1 and sVEGFR3 as compared to those without graft reaction, as was also the case with eyes with postoperative corneal vascularization.

Conclusions:

Graft reaction occurs more often in corneas with increased VEGFA and VEGFC and decreased sVEGFR1, sVEGFR2 and sVEGFR3. Elevated soluble receptors act as a sink for VEGF, and thus as suppressors of angiogenesis and limphangiogenesis may prevent graft reaction and could be a possible best option for anti rejection therapy

Financial Disclosure:

None