Abstract
Due to several corneal diseases [1] (Table 21.1) and after surgery [2], blood and lymphatic vessels can grow into the normally avascular cornea. This neovascularization starts for both blood and lymphatic vessels at the limbal vascular plexus. Blood vessels impair significantly the visual function of the cornea due to opacification by blood vessels themselves but also by secondary effects such as oedema and lipid keratopathy in the corneal stroma. Lymphangiogenesis in contrast is visually not disturbing, but a key risk factor for immune reactions after corneal transplantation [3]. Hem- and lymphangiogenesis do not only occur as a consequence of diseases but can also be the reason for infectious or inflammatory corneal diseases. Both hem- and lymphangiogenesis are an essential part of the worldwide most frequent reasons for corneal blindness (trachoma) [4] and the most frequent reason for infectious blindness – herpetic keratitis – in the western civilization [5].
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Cursiefen C, Kuchle M, Naumann GO. Angiogenesis in corneal diseases: histopathologic evaluation of 254 human corneal buttons with neovascularization. Cornea. 1998;17:611–3.
Cursiefen C, Martus P, Nguyen NX, Langenbucher A, Seitz B, Kuchle M. Corneal neovascularization after nonmechanical versus mechanical corneal trephination for non-high-risk keratoplasty. Cornea. 2002;21:648–52.
Hou Y, Le VNH, Clahsen T, Schneider AC, Bock F, Cursiefen C. Photodynamic therapy leads to time-dependent regression of pathologic corneal (lymph) angiogenesis and promotes high-risk corneal allograft survival. Invest Ophthalmol Vis Sci. 2017;58:5862–9. https://doi.org/10.1167/iovs.17-22904.
Whitcher JP, Srinivasan M, Upadhyay MP. Corneal blindness: a global perspective. Bull World Health Organ. 2001;79:214–21.
Pepose JS, Leib DA, Stuart PM, Easty EL. Herpes simplex virus disease: anterior segment of the eye. St Louis: Mosby-Year-Book; 1996.
Bock F, Maruyama K, Regenfuss B, Hos D, Steven P, Heindl LM, Cursiefen C. Novel anti(lymph)angiogenic treatment strategies for corneal and ocular surface diseases. Prog Retin Eye Res. 2013;34:89–124. https://doi.org/10.1016/j.preteyeres.2013.01.001.
Chang JH, Gabison EE, Kato T, Azar DT. Corneal neovascularization. Curr Opin Ophthalmol. 2001;12:242–9.
Cursiefen C, Masli S, Ng TF, Dana MR, Bornstein P, Lawler J, Streilein JW. Roles of thrombospondin-1 and -2 in regulating corneal and iris angiogenesis. Invest Ophthalmol Vis Sci. 2004;45:1117–24.
Cursiefen C, Chen L, Saint-Geniez M, Hamrah P, Jin Y, Rashid S, Pytowski B, Persaud K, Wu Y, Streilein JW, Dana R. Nonvascular VEGF receptor 3 expression by corneal epithelium maintains avascularity and vision. Proc Natl Acad Sci U S A. 2006;103:11405–10.
Singh N, Tiem M, Watkins R, Cho YK, Wang Y, Olsen T, Uehara H, Mamalis C, Luo L, Oakey Z, Ambati BK. Soluble vascular endothelial growth factor receptor 3 is essential for corneal alymphaticity. Blood. 2013;121:4242–9. https://doi.org/10.1182/blood-2012-08-453043.
Albuquerque RJ, Hayashi T, Cho WG, Kleinman ME, Dridi S, Takeda A, Baffi JZ, Yamada K, Kaneko H, Green MG, Chappell J, Wilting J, Weich HA, Yamagami S, Amano S, Mizuki N, Alexander JS, Peterson ML, Brekken RA, Hirashima M, Capoor S, Usui T, Ambati BK, Ambati J. Alternatively spliced vascular endothelial growth factor receptor-2 is an essential endogenous inhibitor of lymphatic vessel growth. Nat Med. 2009;15:1023–30. https://doi.org/10.1038/nm.2018.
Bock F, Onderka J, Braun G, Schneider AC, Hos D, Bi Y, Bachmann BO, Cursiefen C. Identification of novel endogenous anti(lymph)angiogenic factors in the aqueous humor. Invest Ophthalmol Vis Sci. 2016;57:6554–60. https://doi.org/10.1167/iovs.15-18526.
Cursiefen C, Rummelt C, Kuchle M. Immunohistochemical localization of vascular endothelial growth factor, transforming growth factor alpha, and transforming growth factor beta1 in human corneas with neovascularization. Cornea. 2000;19:526–33.
Mastyugin V, Mosaed S, Bonazzi A, Dunn MW, Schwartzman ML. Corneal epithelial VEGF and cytochrome P450 4B1 expression in a rabbit model of closed eye contact lens wear. Curr Eye Res. 2001;23:1–10.
Zheng M, Deshpande S, Lee S, Ferrara N, Rouse BT. Contribution of vascular endothelial growth factor in the neovascularization process during the pathogenesis of herpetic stromal keratitis. J Virol. 2001;75:9828–35.
Zheng M, Schwarz MA, Lee S, Kumaraguru U, Rouse BT. Control of stromal keratitis by inhibition of neovascularization. Am J Pathol. 2001;159:1021–9.
Zhu SN, Dana MR. Expression of cell adhesion molecules on limbal and neovascular endothelium in corneal inflammatory neovascularization. Invest Ophthalmol Vis Sci. 1999;40:1427–34.
Cursiefen C, Chen L, Dana MR, Streilein JW. Corneal lymphangiogenesis: evidence, mechanisms, and implications for corneal transplant immunology. Cornea. 2003;22:273–81.
Cursiefen C, Schlotzer-Schrehardt U, Kuchle M, Sorokin L, Breiteneder-Geleff S, Alitalo K, Jackson D. Lymphatic vessels in vascularized human corneas: immunohistochemical investigation using LYVE-1 and podoplanin. Invest Ophthalmol Vis Sci. 2002;43:2127–35.
Cursiefen C, Chen L, Borges LP, Jackson D, Cao J, Radziejewski C, D’Amore PA, Dana MR, Wiegand SJ, Streilein JW. VEGF-A stimulates lymphangiogenesis and hemangiogenesis in inflammatory neovascularization via macrophage recruitment. J Clin Invest. 2004;113:1040–50. https://doi.org/10.1172/JCI20465.
Benjamin LE, Golijanin D, Itin A, Pode D, Keshet E. Selective ablation of immature blood vessels in established human tumors follows vascular endothelial growth factor withdrawal. J Clin Invest. 1999;103:159–65.
Cursiefen C, Hofmann-Rummelt C, Kuchle M, Schlotzer-Schrehardt U. Pericyte recruitment in human corneal angiogenesis: an ultrastructural study with clinicopathological correlation. Br J Ophthalmol. 2003;87:101–6.
Le VNH, Schneider AC, Scholz R, Bock F, Cursiefen C. Fine needle-diathermy regresses pathological corneal (lymph)angiogenesis and promotes high-risk corneal transplant survival. Sci Rep. 2018;8:5707. https://doi.org/10.1038/s41598-018-24037-3.
Hou Y, Le VNH, Toth G, Siebelmann S, Horstmann J, Gabriel T, Bock F, Cursiefen C. UV light crosslinking regresses mature corneal blood and lymphatic vessels and promotes subsequent high-risk corneal transplant survival. Am J Transplant. 2018;18:2873–84. https://doi.org/10.1111/ajt.14874.
Goyal S, Chauhan SK, El Annan J, Nallasamy N, Zhang Q, Dana R. Evidence of corneal lymphangiogenesis in dry eye disease: a potential link to adaptive immunity? Arch Ophthalmol. 2010;128:819–24. https://doi.org/10.1001/archophthalmol.2010.124.
Hos D, Bukowiecki A, Horstmann J, Bock F, Bucher F, Heindl LM, Siebelmann S, Steven P, Dana R, Eming SA, Cursiefen C. Transient ingrowth of lymphatic vessels into the physiologically avascular cornea regulates corneal edema and transparency. Sci Rep. 2017;7:7227. https://doi.org/10.1038/s41598-017-07806-4.
Huang M, Wang B, Wan P, Liang X, Wang X, Liu Y, Zhou Q, Wang Z. Roles of limbal microvascular net and limbal stroma in regulating maintenance of limbal epithelial stem cells. Cell Tissue Res. 2015;359:547–63. https://doi.org/10.1007/s00441-014-2032-4.
Notara M, Alatza A, Gilfillan J, Harris AR, Levis HJ, Schrader S, Vernon A, Daniels JT. In sickness and in health: corneal epithelial stem cell biology, pathology and therapy. Exp Eye Res. 2010;90:188–95. https://doi.org/10.1016/j.exer.2009.09.023.
Notara M, Refaian N, Braun G, Steven P, Bock F, Cursiefen C. Short-term uvb-irradiation leads to putative limbal stem cell damage and niche cell-mediated upregulation of macrophage recruiting cytokines. Stem Cell Res. 2015;15:643–54. https://doi.org/10.1016/j.scr.2015.10.008.
Dietrich T, Bock F, Yuen D, Hos D, Bachmann BO, Zahn G, Wiegand S, Chen L, Cursiefen C. Cutting edge: lymphatic vessels, not blood vessels, primarily mediate immune rejections after transplantation. J Immunol. 2010;184:535–9. https://doi.org/10.4049/jimmunol.0903180.
Reuer T, Schneider AC, Cakir B, Buhler AD, Walz JM, Lapp T, Lange C, Agostini H, Schlunck G, Cursiefen C, Reinhard T, Bock F, Stahl A. Semaphorin 3F modulates corneal lymphangiogenesis and promotes corneal graft survival. Invest Ophthalmol Vis Sci. 2018;59:5277–84. https://doi.org/10.1167/iovs.18-24287.
Maguire MG, Stark WJ, Gottsch JD, Stulting RD, Sugar A, Fink NE, Schwartz A. Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies. Collaborative Corneal Transplantation Studies Research Group. Ophthalmology. 1994;101:1536–47.
Kuchle M, Cursiefen C, Nguyen NX, Langenbucher A, Seitz B, Wenkel H, Martus P, Naumann GO. Risk factors for corneal allograft rejection: intermediate results of a prospective normal-risk keratoplasty study. Graefes Arch Clin Exp Ophthalmol. 2002;240:580–4.
Schroedl F, Kaser-Eichberger A, Schlereth SL, Bock F, Regenfuss B, Reitsamer HA, Lutty GA, Maruyama K, Chen L, Lutjen-Drecoll E, Dana R, Kerjaschki D, Alitalo K, De Stefano ME, Junghans BM, Heindl LM, Cursiefen C. Consensus statement on the immunohistochemical detection of ocular lymphatic vessels. Invest Ophthalmol Vis Sci. 2014;55:6440–2. https://doi.org/10.1167/iovs.14-15638.
Liu Y, Hamrah P, Zhang Q, Taylor AW, Dana MR. Draining lymph nodes of corneal transplant hosts exhibit evidence for donor major histocompatibility complex (MHC) class II-positive dendritic cells derived from MHC class II-negative grafts. J Exp Med. 2002;195:259–68.
Yamagami S, Dana MR. The critical role of lymph nodes in corneal alloimmunization and graft rejection. Invest Ophthalmol Vis Sci. 2001;42:1293–8.
Dana MR, Schaumberg DA, Kowal VO, Goren MB, Rapuano CJ, Laibson PR, Cohen EJ. Corneal neovascularization after penetrating keratoplasty. Cornea. 1995;14:604–9.
Chan WK, Weissman BA. Corneal pannus associated with contact lens wear. Am J Ophthalmol. 1996;121:540–6.
Donnenfeld ED, Ingraham H, Perry HD, Imundo M, Goldberg LP. Contact lens-related deep stromal intracorneal hemorrhage. Ophthalmology. 1991;98:1793–6.
Bock F, Matthaei M, Reinhard T, Bohringer D, Christoph J, Ganslandt T, Cursiefen C. High-dose subconjunctival cyclosporine a implants do not affect corneal neovascularization after high-risk keratoplasty. Ophthalmology. 2014;121:1677–82. https://doi.org/10.1016/j.ophtha.2014.03.016.
Becker B. The side effects of corticosteroids. Investig Ophthalmol. 1964;3:492–7.
Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med. 1971;285:1182–6.
Folkman J. Anti-angiogenesis: new concept for therapy of solid tumors. Ann Surg. 1972;175:409–16.
Bock F, Konig Y, Kruse F, Baier M, Cursiefen C. Bevacizumab (Avastin) eye drops inhibit corneal neovascularization. Graefes Arch Clin Exp Ophthalmol. 2008;246:281–4.
Nyberg P, Xie L, Kalluri R. Endogenous inhibitors of angiogenesis. Cancer Res. 2005;65:3967–79.
Lafleur MA, Handsley MM, Edwards DR. Metalloproteinases and their inhibitors in angiogenesis. Expert Rev Mol Med. 2003;2003:1–39.
Cursiefen C, Cao J, Chen L, Liu Y, Maruyama K, Jackson D, Kruse FE, Wiegand SJ, Dana MR, Streilein JW. Inhibition of hemangiogenesis and lymphangiogenesis after normal-risk corneal transplantation by neutralizing VEGF promotes graft survival. Invest Ophthalmol Vis Sci. 2004;45:2666–73.
Cursiefen C, Ikeda S, Nishina PM, Smith RS, Ikeda A, Jackson D, Mo JS, Chen L, Dana MR, Pytowski B, Kruse FE, Streilein JW. Spontaneous corneal hem- and lymphangiogenesis in mice with destrin-mutation depend on VEGFR3 signaling. Am J Pathol. 2005;166:1367–77.
Presta LG, Chen H, O’Connor SJ, Chisholm V, Meng YG, Krummen L, Winkler M, Ferrara N. Humanization of an anti-vascular endothelial growth factor monoclonal antibody for the therapy of solid tumors and other disorders. Cancer Res. 1997;57:4593–9.
Dastjerdi MH, Al-Arfaj KM, Nallasamy N, Hamrah P, Jurkunas UV, Pineda R 2nd, Pavan-Langston D, Dana R. Topical bevacizumab in the treatment of corneal neovascularization: results of a prospective, open-label, noncomparative study. Arch Ophthalmol. 2009;127:381–9. https://doi.org/10.1001/archophthalmol.2009.18.
Bock F, Onderka J, Dietrich T, Bachmann B, Kruse FE, Paschke M, Zahn G, Cursiefen C. Bevacizumab as a potent inhibitor of inflammatory corneal angiogenesis and lymphangiogenesis. Invest Ophthalmol Vis Sci. 2007;48:2545–52. https://doi.org/10.1167/iovs.06-0570.
Ferrara N, Chen H, Davis-Smyth T, Gerber HP, Nguyen TN, Peers D, Chisholm V, Hillan KJ, Schwall RH. Vascular endothelial growth factor is essential for corpus luteum angiogenesis. Nat Med. 1998;4:336–40.
Gerber HP, Vu TH, Ryan AM, Kowalski J, Werb Z, Ferrara N. VEGF couples hypertrophic cartilage remodeling, ossification and angiogenesis during endochondral bone formation. Nat Med. 1999;5:623–8.
Holash J, Davis S, Papadopoulos N, Croll SD, Ho L, Russell M, Boland P, Leidich R, Hylton D, Burova E, Ioffe E, Huang T, Radziejewski C, Bailey K, Fandl JP, Daly T, Wiegand SJ, Yancopoulos GD, Rudge JS. VEGF-Trap: a VEGF blocker with potent antitumor effects. Proc Natl Acad Sci U S A. 2002;99:11393–8.
Bachmann BO, Bock F, Wiegand SJ, Maruyama K, Dana MR, Kruse FE, Luetjen-Drecoll E, Cursiefen C. Promotion of graft survival by vascular endothelial growth factor a neutralization after high-risk corneal transplantation. Arch Ophthalmol. 2008;126:71–7. https://doi.org/10.1001/archopht.126.1.71.
Bachmann BO, Luetjen-Drecoll E, Bock F, Wiegand SJ, Hos D, Dana R, Kruse FE, Cursiefen C. Transient postoperative vascular endothelial growth factor (VEGF)-neutralisation improves graft survival in corneas with partly regressed inflammatory neovascularisation. Br J Ophthalmol. 2009;93:1075–80. https://doi.org/10.1136/bjo.2008.145128.
Salabarria AC, Braun G, Heykants M, Koch M, Reuten R, Mahabir E, Cursiefen C, Bock F. Local VEGF-A blockade modulates the microenvironment of the corneal graft bed. Am J Transplant. 2019; https://doi.org/10.1111/ajt.15331.
Cursiefen C, Bock F, Horn FK, Kruse FE, Seitz B, Borderie V, Fruh B, Thiel MA, Wilhelm F, Geudelin B, Descohand I, Steuhl KP, Hahn A, Meller D. GS-101 antisense oligonucleotide eye drops inhibit corneal neovascularization: interim results of a randomized phase II trial. Ophthalmology. 2009;116:1630–7. https://doi.org/10.1016/j.ophtha.2009.04.016.
Koenig Y, Bock F, Kruse FE, Stock K, Cursiefen C. Angioregressive pretreatment of mature corneal blood vessels before keratoplasty: fine-needle vessel coagulation combined with anti-VEGFs. Cornea. 2012;31:887–92. https://doi.org/10.1097/ICO.0b013e31823f8f7a.
Brooks BJ, Ambati BK, Marcus DM, Ratanasit A. Photodynamic therapy for corneal neovascularisation and lipid degeneration. Br J Ophthalmol. 2004;88:840.
Morisada T, Oike Y, Yamada Y, Urano T, Akao M, Kubota Y, Maekawa H, Kimura Y, Ohmura M, Miyamoto T, Nozawa S, Koh GY, Alitalo K, Suda T. Angiopoietin-1 promotes LYVE-1-positive lymphatic vessel formation. Blood. 2005;105:4649–56. https://doi.org/10.1182/blood-2004-08-3382.
Song SH, Kim KL, Lee KA, Suh W. Tie1 regulates the Tie2 agonistic role of angiopoietin-2 in human lymphatic endothelial cells. Biochem Biophys Res Commun. 2012;419:281–6. https://doi.org/10.1016/j.bbrc.2012.02.009.
Tammela T, Saaristo A, Holopainen T, Yla-Herttuala S, Andersson LC, Virolainen S, Immonen I, Alitalo K. Photodynamic ablation of lymphatic vessels and intralymphatic cancer cells prevents metastasis. Sci Transl Med. 2011;3:69ra11. https://doi.org/10.1126/scitranslmed.3001699.
Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol. 2003;135:620–7.
Kohlhaas M, Spoerl E, Speck A, Schilde T, Sandner D, Pillunat LE. A new treatment of keratectasia after LASIK by using collagen with riboflavin/UVA light cross-linking. Klin Monatsbl Augenheilkd. 2005;222:430–6. https://doi.org/10.1055/s-2005-857950.
Goodrich RP. The use of riboflavin for the inactivation of pathogens in blood products. Vox Sang. 2000;78(Suppl 2):211–5.
Tabibian D, Richoz O, Hafezi F. PACK-CXL: corneal cross-linking for treatment of infectious keratitis. J Ophthalmic Vis Res. 2015;10:77–80. https://doi.org/10.4103/2008-322X.156122.
Le VNH, Hou Y, Horstmann J, Bock F, Cursiefen C. Novel method to detect corneal lymphatic vessels in vivo by intrastromal injection of fluorescein. Cornea. 2018;37:267–71. https://doi.org/10.1097/ICO.0000000000001444.
Horstmann J, Schulz-Hildebrandt H, Bock F, Siebelmann S, Lankenau E, Huttmann G, Steven P, Cursiefen C. Label-free in vivo imaging of corneal lymphatic vessels using microscopic optical coherence tomography. Invest Ophthalmol Vis Sci. 2017;58:5880–6. https://doi.org/10.1167/iovs.17-22286.
Acknowledgment
We appreciate support from DFG Research Unit FOR2240 (www.for2240.de), EU Arrest Blindness (www.arrestblindness.eu) and EU Cost Action Biocornea (www.biocornea.eu).
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Bock, F., Cursiefen, C. (2020). Corneal Angiogenesis and Lymphangiogenesis. In: Colby, K., Dana, R. (eds) Foundations of Corneal Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-25335-6_21
Download citation
DOI: https://doi.org/10.1007/978-3-030-25335-6_21
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-25334-9
Online ISBN: 978-3-030-25335-6
eBook Packages: MedicineMedicine (R0)