Building a treatment strategy for neovascular glaucoma in the era of anti-VEGF therapy targeting matricellular proteins

2022 Fiscal Year Final Research Report

• Project/Area Number: 21K16876
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56060:Ophthalmology-related
• Research Institution: Kyushu University
• Principal Investigator: Nakama Takahito 九州大学, 医学研究院, 共同研究員 (30827556)
• Project Period (FY): 2021-04-01 – 2023-03-31
• Keywords: 血管新生緑内障 / 線維血管増殖 / 抗VEGF療法 / マトリセルラー蛋白

Outline of Final Research Achievements

Approximately 80% of the neovascular glaucoma cases that underwent surgical intervention had received anti-VEGF therapy prior to surgery. The surgery was conducted at angle-closure glaucoma stage that showed fibrovascular membrane overlying drainage angle. Additionally, there were several cases that required further additional procedures due to postoperative fibrosis.
Analysis of aqueous humor showed the significant high levels of matricellular proteins, including periostin and tenascin-C, in neovascular glaucoma cases. Now we investigate the correlation of these proteins with the clinical manifestations of the disease, and also study the functional analysis of these proteins in neovascular glaucoma.

Free Research Field

線維血管増殖

Academic Significance and Societal Importance of the Research Achievements

抗VEGF療法を含む集学的治療を行っても制御が困難な難治性血管新生緑内障の治療の実態を詳しく検討し、実情を把握出来た。検討結果から、抗VEGF療法を含む血管新生のみを標的とした治療のみでは制御困難な症例が多く存在し、線維増殖を標的とした新規治療が必要であることが考えられた。
線維増殖への関与が考えられるペリオスチンやテネイシンCを含むマトリセルラー蛋白が血管新生緑内障症例で上昇していたことから、マトリセルラー蛋白を標的とした治療が、抗VEGF療法を含む集学的治療を行っても制御困難な難治性血管新生緑内障に対する新規治療となり得ると考えられた。