Clinical Study of “Lingqi Huangban Granule” in Treating Choroidal Neovascularisation in Pathologic Myopia

Objectives: To study the therapeutic effects of “Lingqi Huangban Granule” (LQHB) combined with intravitreal ranibizumab injection (IVR) for choroidal neovascularisation (CNV) in pathologic myopia (PM). Methods: This was a prospective, comparative, interventional study. Eighty eyes of eighty consecutive patients with myopic CNV were randomized into control group (IVR, 40 eyes) and integrative therapy group (IVR + LQHB, 40 eyes), each with a follow-up period of 12 months. IVR was given with an “on demand” regimen (Pro re nata, PRN). Final best corrected visual acuity (BCVA) and its change from baseline were the main outcome measures. Changes in optical coherence tomography (OCT) and central retinal thickness (CRT) were the secondary outcome measures. Results: BCVA of patients in the integrative group improved significantly (from 47.10 ± 13.51 letters to 90.72 ± 12.98 letter, P 0.05), more than in the control group (from 42.90 ± 13.18 letters to 69.18±13.21 letters, P 0.05) since the third month after the initial treatment to the end of the follow-up. Mean OCT CRT reduced from 364.75 ± 69.31 to 278.93 ± 33.05 um (P 0.05) in the control group and from 370.73 ± 65.31 to 271.73 ± 46.44 um (P 0.05) in the integrative group, respectively. The mean number of intravitreal injections in the 1-year follow-up was also reduced. No ocular or systemic side effects were observed. Conclusion: LQHB combined with IVR therapy was an effective treatment for stabilizing and improving vision with fewer intravitreal injections. It appears to be an interesting option for this type of patient.

Rac1 activates HIF-1 in laser induced choroidal neovascularization

AIM: To study the effect of Rac1 on the induction of HIF-1 alpha in choroidal neovascularization (CNV) in mice. METHODS: One hundred C57BL/6J mice were laser photocoagulated to induce CNV, fifty mice of that were selected randomly for intravitreal injection of Rac1 inhibitor NSC23766 solution (1 mu L). After laser photocoagulation, fundus fluorescein angiography (FFA) was performed to verify the growth of CNV. Immunohistochemistry and Western blot were used to detect HIF-1 alpha and Rac1 in posterior segment of eye globes. RESULTS: FFA verified that incidence of CNV was significantly reduced in the eyes with NSC23766 injection comparing with that of eyes without NSC23766 injection (P< 0.01). Immunohistochemistry detected that HIF-1 alpha and Rac1 mainly Expressed in the new fibrovascular tissue. Western blot showed that HIF-1 alpha and Rac1 was highly increased in tissue explants of retinal pigment epithelium (RPE) and choroid without NSC23766 injection. But for tissue explants of RPE and choroid with N5C23766 injection, both the expressions of HIF-1 alpha and Rac1 were inhibited. CONCLUSION: Rac1 is crucial to activate HIF-1 regulating the growth of CNV, and its inhibition may have potential therapeutic value.