Ciliary epithelium may provide target for neovascular glaucoma treatment

The results of this laboratory study suggest that the nonpigmented ciliary epithelium is an important site of VEGF synthesis in neovascular glaucoma and may represent a new target for therapy, especially in eyes that are nonresponsive to panretinal photocoagulation.

The authors say the results also provide an explanation for treatment resistance to panretinal photocoagulation found in some cases of iris neovascularization secondary to ischemic retinal disorders.

They investigated the presence of VEGF in the ciliary epithelium by immunohistochemical analysis (VEGF protein) and in situ hybridization (VEGF messenger RNA) in 16 enucleated eyes (8 with intractable neovascular glaucoma and 8 controls).

In eyes with neovascular glaucoma, they found strong VEGF immunoreaction in the nonpigmented epithelial cells of the ciliary processes and in the retina. In situ hybridization for VEGF messenger RNA revealed a similar pattern, with positive stain results only in eyes with neovascular glaucoma. A minimal amount of VEGF immunostaining was seen in control eyes.