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CD11b and CD200 on Circulating Monocytes Differentiate Two Angiographic Subtypes of Polypoidal Choroidal Vasculopathy
Yousif Subhi1,2, Marie Krogh Nielsen1,2, Christopher Rue Molbech1,2
1Clinical Eye Research Division, Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark.
Insights
Polypoidal choroidal vasculopathy (PCV) shows distinct monocyte profiles, with increased CD11b+ and CD200+ monocytes in type 1 PCV. These findings suggest immunological heterogeneity in PCV linked to vascular network development.
Area of Science:
- Ophthalmology
- Immunology
- Vascular Biology
Background:
- Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration.
- Understanding the immunological underpinnings of PCV is crucial for developing targeted therapies.
Purpose of the Study:
- To investigate the surface expression of CD11b and CD200 on circulating monocytes in patients with PCV.
- To compare these monocyte profiles with those in healthy controls and patients with neovascular AMD.
- To examine differences in monocyte expression between PCV subtypes based on branching vascular network (BVN) presence.
Main Methods:
- Prospective case-control study involving PCV patients (n=27), healthy controls (n=27), and neovascular AMD patients (n=49).
- Comprehensive ocular examinations and angiography (fluorescein and indocyanine green) were performed.
- Flow cytometry analyzed monocyte surface expression of CD11b and CD200 after fluorescent antibody staining.
Main Results:
- CD11b+ monocytes were elevated in both PCV and neovascular AMD patients.
- CD200+ and CD11b+CD200+ monocytes were increased in neovascular AMD patients.
- PCV type 1 (strong BVN) showed significantly higher CD11b+, CD200+, and CD11b+CD200+ monocytes compared to PCV type 2 and controls.
Conclusions:
- PCV exhibits immunological heterogeneity, with distinct monocyte profiles correlating with angiographic subtypes.
- Elevated CD11b+ and CD200+ monocytes in PCV type 1 suggest a link between BVN development, retinal injury, and VEGF-mediated processes.
- Systemic monocyte changes may reflect or drive the progression of PCV.
Purpose:
To investigate surface expression of CD11b and CD200 on circulating monocytes in patients with polypoidal choroidal vasculopathy (PCV).
Methods:
This was a prospective case-control study of patients with PCV (n = 27), age-matched healthy controls (n = 27), and patients with neovascular AMD (n = 49). All participants underwent a comprehensive ocular examination. Fluorescein and indocyanine green angiography were performed in patients suspected of neovascular AMD or PCV. Polypoidal choroidal vasculopathy was angiographically categorized into those with a strong presence of a branching vascular network (BVN) (type 1) or with a faint/no clear presence of a BVN (type 2). Fresh venous blood was stained with fluorescent antibodies for flow cytometric analyses. We compared the percentages of CD11b+, CD200+, and CD11b+CD200+ monocytes between groups of diagnosis and between different angiographic subtypes of PCV.
Results:
Overall, CD11b+ monocytes were both increased in patients with PCV and neovascular AMD. CD200+ and CD11b+CD200+ monocytes were increased in patients with neovascular AMD. An age-related increase in CD11b+CD200+ monocytes was absent in patients with PCV and neovascular AMD. Patients with PCV type 1 had significantly higher CD11b+, CD200+, and CD11b+CD200+ monocytes, whereas patients with PCV type 2 had levels similar to that in healthy controls.
Conclusions:
We found that PCV is immunologically heterogeneous with significant differences between angiographic subtypes. Increased CD11b+ and CD200+ monocytes in those with a strong presence of BVN indicate that BVN development may be associated with retinal injury and a VEGF-mediated process that is either reflected or propelled by systemic changes in monocytes.
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