A COMPARISON OF HYPOXIA-INDUCIBLE FACTOR-α IN SURGICALLY EXCISED NEOVASCULAR MEMBRANES OF PATIENTS WITH DIABETES COMPARED WITH IDIOPATHIC EPIRETINAL MEMBRANES IN NONDIABETIC PATIENTS

Purpose: The purpose of this study was to first determine whether hypoxia-inducible factor-1 alpha (HIF-1 alpha) was detectable in diabetic preretinal membranes and to compare the presence of HIF-1 alpha in fibrovascular proliferative diabetic retinopathy membranes with nondiabetic, idiopathic, epiretinal membranes. Methods: Twelve patients with proliferative diabetic retinopathy membranes requiring pars plana vitrectomy and nine nondiabetic patients with idiopathic epiretinal membranes requiring pars plana vitrectomy underwent excision of these membranes. Immunohistochemical staining for the presence of HIF-1 alpha was performed on the excised membranes. The degree of staining for HIF-1 alpha (1+, 2+, and 3+ scale) and the cellular location of staining were determined for each specimen. Institutional Review Board approval and informed consent were obtained for all patients. Results: Eleven of 12 (92%) diabetic preretinal membranes were positive for HIF-1 alpha, and most had intense (2+ to 3+) cytoplasmic staining with occasional focal nuclear positivity. Five of 9 (55%) nondiabetic epiretinal membranes were positive for HIF-1 alpha with significantly weaker cytoplasmic staining (1+ to 2+) with occasional focal punctuate nuclear staining. Conclusion: Hypoxia-inducible factor-1 alpha is found more often and more intensely in diabetic preretinal membranes compared with nondiabetic idiopathic epiretinal membranes. RETINA 30: 1472-1478, 2010