Role of oxidative stress and vascular endothelial growth factor expression in pterygium pathogenesis and prevention of p
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ORIGINAL PAPER
Role of oxidative stress and vascular endothelial growth factor expression in pterygium pathogenesis and prevention of pterygium recurrence after surgical excision Sameh Mohamed Elgouhary Noha Rabie Bayomy
. Hesham Fouad Elmazar . Mariana Ibrahim Naguib .
Received: 29 November 2019 / Accepted: 22 May 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To assess the roles of oxidative stress and vascular endothelial growth factor (VEGF) in pterygium pathogenesis and prevention of pterygium recurrence after surgical excision. Methods Surgically removed pterygium tissue from 35 pterygium patients and normal conjunctival samples from 15 patients matched for age and sex (used as controls) constituted the study samples. The conjunctival samples were preserved at - 80 °C until analysis. Catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GSH) and total antioxidant (TAO) enzymatic activity and the levels of nitric oxide (NO), malondialdehyde (MDA) and VEGF were studied in both groups. To evaluate the recurrence rate after surgical excision, the pterygium patients were further subdivided into three groups according to the adjuvant therapy used to prevent recurrence. Group 1 consisted of 10 patients who were treated with 0.2 mg mitomycin-c (MMC) for 2 min. Group 2
consisted of 12 patients treated with subconjunctival bevacizumab injection after surgical removal of the pterygium. Group 3 consisted of 13 patients who underwent combined treatment with 0.2 mg of MMC for 2 min and subconjunctival bevacizumab injection. The follow-up of patients in the three groups ranged from 7 to 15 months. Results The activities of CAT, SOD, GSH and TAO were significantly lower in pterygium samples than in normal conjunctival samples (p \ 0.0001 each). The levels of MDA (p = 0.046), NO (p \ 0.0001) and VEGF (p \ 0.0001) were significantly higher in pterygium patients than in controls. The lowest recurrence rate after surgical excision was that of the third group. Conclusions Oxidative stress and VEGF could play a role in the pathogenesis of pterygium as indicated by decreased antioxidant enzymatic activity and increased levels of VEGF in the pterygium tissue and the role of MMC and anti-VEGF therapy in decreasing the recurrence rate after surgical excision.
S. M. Elgouhary (&) H. F. Elmazar Department of Ophthalmology, Menoufia University, Shibin Elkom, Egypt e-mail: [email protected]
Keywords
M. I. Naguib Benha Ophthalmic Hospital, Benha, Egypt
Introduction
N. R. Bayomy Department of Medical Biochemistry and Molecular Biology, Menoufia University, Shibin Elkom, Egypt
Pterygium Oxidative stress VEGF
Pterygium, a triangular hyperplasia of the conjunctival tissue crossing the cornea, is a highly vascular tissue with epithelium [1]. The typical nasal location of the
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Int Ophthalmol
pterygium may be due to the focusing of the sunlight on the nasal cornea [2–4]. Predisposing factors for pterygium formation include ultraviolet (UV) rays, irrit
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