ABSTRACT
ObjectiveTo investigate the effects of Mingjing granules （MJKL） on the fibrovascular membrane of experimental wet age-related macular degeneration （nAMD） based on macrophages and glial cells and further explain the mechanism of MJKL in the treatment of nAMD. MethodThe experimental nAMD fibrovascular membrane model was established by two-stage laser photocoagulation. BN rats were randomly divided into three groups： model group， anti-vascular endothelial growth factor （VEGF） group， and MJKL + anti-VEGF group. The model group was given distilled water for intragastric administration. Anti-VEGF group was injected with leizumab injection in the vitreous cavity. MJKL + anti-VEGF group was injected with leizumab injection in the vitreous cavity， and MJKL was intragastrically administered. Ten normal BN rats were not modeled and fed as controls. After 40 days of model making， fundus lesion morphology， lesion exudation area， and MD value were observed by fundus photography （FP）， fundus angiography （FFA）， optical coherence tomography （OCT）， and retinal pigment epithelium （RPE）-choroid-sclera film. The changes in retinal structure were observed by histopathology， and the expression and distribution of F4/80， Iba-1， and GFAP were detected by immunofluorescence. The relative expression levels of F4/80， Iba-1， and GFAP mRNA were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultThe fibrovascular membrane model was established 40d after two-stage laser modeling. The lesion exudation area， MD value， lesion height， and lesion area in the anti-VEGF group were significantly lower than those in the model group （P<0.05）， and the retinal structural damage degree was significantly improved. Compared with the anti-VEGF group， the MJKL + anti-VEGF group significantly decreased the MD value， lesion height， and lesion area （P<0.05）， and lesion area and retinal structural damage degree were significantly improved. The fluorescence intensity of F4/80 and Iba-1 in the model group was significantly higher than that in the normal group （P<0.05）， and that in the anti-VEGF group was significantly lower than that in the model group （P<0.05）. The fluorescence intensity in the MJKL + anti-VEGF group was significantly lower than that in the anti-VEGF group （P<0.05）. The fluorescence intensity of GFAP in the model group was significantly higher than that in the normal group （P<0.05）， and that in the anti-VEGF group was significantly lower than that in the model group （P<0.05）. The relative expression levels of F4/80， Iba-1， and GFAP mRNA in the model group were significantly increased compared with the normal group （P<0.05）， and the anti-VEGF group was significantly decreased compared with the model group （P<0.05）. The relative expression levels of F4/80， Iba-1， and GFAP mRNA in the MJKL + anti-VEGF group were significantly decreased compared with those in the anti-VEGF group （P<0.05）. ConclusionMJKL combined with anti-VEGF drugs can inhibit the growth of experimental nAMD fibrovascular membrane better than anti-VEGF drugs alone， and the mechanism may be related to inhibiting the participation of macrophages and glial cells in the formation of fibrovascular membrane.
ABSTRACT
PURPOSE: To report a case of an anterior fibrovascular membrane following cataract extraction and intraocular lens implantation in a patient with congenital aniridia. CASE SUMMARY: A 13-year-old girl presented with congenital aniridia and cataracts in both eyes. She underwent cataract extraction by phacoemulcification with intraocular lens implantation. Six months after cataract surgery, a progressive anterior chamber fibrovascular membrane was noted in both intraocular lens and rudimentary iris. Surgical excision of the fibrovascular membrane was performed, but there was recurrence after five weeks in both eyes. Subsequent surgical intervention on both eyes involved intraocular lens explantation combined with membranectomy to prevent recurrence and phthisis. Surgical findings indicated that the fibrovascular membrane involved the retrolenticular space, and histopathological evidence indicated that the extensive fibrotic tissue originated from the root of the rudimentary iris. CONCLUSIONS: Patients with congenital aniridia should be monitored carefully for the development of intraocular fibrosis after intraocular lens implantation. If a fibrovascular membrane is noted, early surgical intervention is recommended, and the explantation of the intraocular lens should be considered during surgical intervention to prevent recurrence and complications.