1
|
Curran ALK, Stukin J, Ambrosio L, Mantagos IS, Wu C, Vanderveen DK, Hansen RM, Akula JD, Fulton AB. Electroretinographic Responses in Retinopathy of Prematurity Treated Using Intravitreal Bevacizumab or Laser. Am J Ophthalmol 2023; 252:275-285. [PMID: 37146743 PMCID: PMC10524994 DOI: 10.1016/j.ajo.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE Intravitreal injection of bevacizumab (IVB) offers advantages over laser photoablation for treatment of type 1 retinopathy of prematurity (ROP). However, retinal function has not, to date, been quantitatively compared following these interventions. Therefore, electroretinography (ERG) was used compare retinal function among eyes treated using IVB or laser, and control eyes. In addition, among the IVB-treated eyes, ERG was used to compare function in individuals in whom subsequent laser was and was not required. DESIGN Prospective clinical cohort study. METHODS ERG was used to record dark- and light-adapted stimulus/response functions in 21 children treated using IVB (12 of whom required subsequent laser in at least 1 eye for persistent avascular retina [PAR]). Sensitivity and amplitude parameters were derived from the a-wave, b-wave, and oscillatory potentials (OPs), representing activity in photoreceptor, postreceptor, and inner retinal cells, respectively. These parameters were then referenced to those of 76 healthy, term-born controls and compared to those of 10 children treated using laser only. RESULTS In children with treated ROP, every ERG parameter was significantly below the mean in controls. However, these significant ERG deficits did not differ between IVB- and laser-treated eyes. Among children treated using IVB, no ERG parameter was significantly associated with dose or need for subsequent laser. CONCLUSION Retinal function was significantly impaired in treated ROP eyes. Function in IVB-treated eyes did not differ from that in laser-treated eyes. Functional differences also did not distinguish those IVB-treated eyes that would subsequently need laser for PAR.
Collapse
Affiliation(s)
| | - Justyna Stukin
- Boston Children’s Hospital, Ophthalmology
- Northeastern University, Behavioral Neuroscience
| | - Lucia Ambrosio
- University of Naples Federico II, Department of Neuroscience, Reproductive and Odontostomatological Sciences
- University of Naples Federico II, Department of Public Health
| | - Iason S. Mantagos
- Boston Children’s Hospital, Ophthalmology
- Harvard Medical School, Ophthalmology
| | - Carolyn Wu
- Boston Children’s Hospital, Ophthalmology
- Harvard Medical School, Ophthalmology
| | | | - Ronald M. Hansen
- Boston Children’s Hospital, Ophthalmology
- Harvard Medical School, Ophthalmology
| | - James D. Akula
- Boston Children’s Hospital, Ophthalmology
- Harvard Medical School, Ophthalmology
| | - Anne B. Fulton
- Boston Children’s Hospital, Ophthalmology
- Harvard Medical School, Ophthalmology
| |
Collapse
|
2
|
De Bruyn H, Hansen RM, Akula JD, Fulton AB. The Development of Retinal Function and Refractive Error in Children With Retinopathy of Prematurity. Invest Ophthalmol Vis Sci 2023; 64:35. [PMID: 37651111 PMCID: PMC10476440 DOI: 10.1167/iovs.64.11.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 07/29/2023] [Indexed: 09/01/2023] Open
Abstract
Purpose The purpose of this study was to test the hypothesis that retinopathy of prematurity (ROP) prolongs development of rod-mediated thresholds for detection of stimuli at 10 degrees but not 30 degrees eccentricity. In addition, to evaluate the thresholds at each site for an association with visual acuity (VA) and spherical equivalent (SE). Methods We estimated rod-mediated dark-adapted thresholds (DATs) for the detection of 2 degree diameter, 50 ms, blue (λ < 510 nm) flashes at 10 degrees and 30 degrees eccentric in former preterm subjects (n = 111), stratified by ROP severity: None (n = 32), Mild (n = 66), and Severe (n = 13). We also tested Term-born (n = 28) controls. To determine the age at half-maximal sensitivity (Agehalf) for each group and eccentricity, we fit DATs to logistic growth curves. We obtained VA and SE for Preterm subjects and evaluated the course of threshold development at 10 degrees and 30 degrees for significant association with VA and SE predicted at age 10 years. Results DAT development at 10 degrees was significantly delayed in ROP (Mild and Severe); ROP did not significantly alter DAT development at 30 degrees. At age 10 years, among Preterm subjects, both VA and SE were significantly associated with group (None,Mild, and Severe). SE was predicted by the course of DAT development at 30 degrees. VA was not associated with the course of DAT development at 10 degrees. Conclusions At 10 degrees, ROP-whether mild or severe-is associated with significant delays in DAT development, evidence that the late-maturing central retina is vulnerable to ROP. The association of 30 degree threshold and myopia are evidence that more peripheral retina is important to refractive development.
Collapse
Affiliation(s)
- Hanna De Bruyn
- Ophthalmology Department, Boston Children's Hospital, Boston, Massachusetts, United States
| | - Ronald M. Hansen
- Ophthalmology Department, Boston Children's Hospital, Boston, Massachusetts, United States
- Ophthalmology Department, Harvard Medical School, Boston, Massachusetts, United States
| | - James D. Akula
- Ophthalmology Department, Boston Children's Hospital, Boston, Massachusetts, United States
- Ophthalmology Department, Harvard Medical School, Boston, Massachusetts, United States
| | - Anne B. Fulton
- Ophthalmology Department, Boston Children's Hospital, Boston, Massachusetts, United States
- Ophthalmology Department, Harvard Medical School, Boston, Massachusetts, United States
| |
Collapse
|
3
|
McAnany JJ, Park JC, Fishman GA, Hyde RA. Spatial and Temporal Integration Abnormalities in X-Linked Retinoschisis. Invest Ophthalmol Vis Sci 2022; 63:22. [PMID: 35984651 PMCID: PMC9419457 DOI: 10.1167/iovs.63.9.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate spatial and temporal integration across the visual field in individuals with juvenile X-linked retinoschisis (XLRS). Methods Nine subjects with XLRS and 10 visually normal individuals participated. Luminance thresholds were measured at 15 locations along the horizontal visual field meridian. Locations were grouped into four regions for analysis: foveal, parafoveal (2°), perifoveal (5°-10°), and peripheral (10°-60°). For spatial integration measurements, stimulus duration was 100 ms, and size ranged from 0.01 to 2.32 deg2 (Goldmann I-V). For temporal integration measurements, stimulus size was 0.15 deg2 (Goldmann III), and duration ranged from 12 to 800 ms. The effect of stimulus size and duration on the subjects' threshold was described using integration models. Results Luminance thresholds for the XLRS group were more elevated for small targets (2.0×-12.6×) than for large targets (1.25×-3.2×) compared to controls for all locations. Likewise, thresholds for the XLRS group were more elevated for short durations (6.3×) than for long durations (4.0×) in the fovea and parafovea but were similarly elevated at all durations (2.0×-2.5×) in the perifovea and periphery. For both the size and duration experiments, thresholds measured in the fovea, parafovea, and perifovea of XLRS subjects were highly similar to those measured from the peripheral field of the controls. Conclusions Spatial and temporal integration characteristics of the XLRS fovea, parafovea, and perifovea are similar to those of the normal periphery. The results also indicate that scaling stimulus size equates thresholds for the XLRS and control subjects throughout the visual field, but scaling duration does not.
Collapse
Affiliation(s)
- J Jason McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States.,Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Jason C Park
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| | - Gerald A Fishman
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States.,The Pangere Center for Inherited Retinal Diseases, The Chicago Lighthouse, Chicago, Illinois, United States
| | - Robert A Hyde
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, United States
| |
Collapse
|
4
|
Liu Y, Kinoshita J, Ivanova E, Sun D, Li H, Liao T, Cao J, Bell BA, Wang JM, Tang Y, Brydges S, Peachey NS, Sagdullaev BT, Romano C. Mouse models of X-linked juvenile retinoschisis have an early onset phenotype, the severity of which varies with genotype. Hum Mol Genet 2020; 28:3072-3090. [PMID: 31174210 DOI: 10.1093/hmg/ddz122] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/04/2019] [Accepted: 06/03/2019] [Indexed: 12/17/2022] Open
Abstract
X-linked juvenile retinoschisis (XLRS) is an early-onset inherited condition that affects primarily males and is characterized by cystic lesions of the inner retina, decreased visual acuity and contrast sensitivity and a selective reduction of the electroretinogram (ERG) b-wave. Although XLRS is genetically heterogeneous, all mouse models developed to date involve engineered or spontaneous null mutations. In the present study, we have studied three new Rs1 mutant mouse models: (1) a knockout with inserted lacZ reporter gene; (2) a C59S point mutant substitution and (3) an R141C point mutant substitution. Mice were studied from postnatal day (P15) to 28 weeks by spectral domain optical coherence tomography and ERG. Retinas of P21-22 mice were examined using biochemistry, single cell electrophysiology of retinal ganglion cells (RGCs) and by immunohistochemistry. Each model developed intraretinal schisis and reductions in the ERG that were greater for the b-wave than the a-wave. The phenotype of the C59S mutant appeared less severe than the other mutants by ERG at adult ages. RGC electrophysiology demonstrated elevated activity in the absence of a visual stimulus and reduced signal-to-noise ratios in response to light stimuli. Immunohistochemical analysis documented early abnormalities in all cells of the outer retina. Together, these results provide significant insight into the early events of XLRS pathophysiology, from phenotype differences between disease-causing variants to common mechanistic events that may play critical roles in disease presentation and progression.
Collapse
Affiliation(s)
- Yang Liu
- Regeneron Pharmaceuticals, Tarrytown, NY 10591, USA
| | - Junzo Kinoshita
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Elena Ivanova
- Burke Neurological Institute at Weill Cornell Medicine, White Plains, NY 10605, USA
| | - Duo Sun
- Regeneron Pharmaceuticals, Tarrytown, NY 10591, USA
| | - Hong Li
- Regeneron Pharmaceuticals, Tarrytown, NY 10591, USA
| | - Tara Liao
- Regeneron Pharmaceuticals, Tarrytown, NY 10591, USA
| | - Jingtai Cao
- Regeneron Pharmaceuticals, Tarrytown, NY 10591, USA
| | - Brent A Bell
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Jacob M Wang
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Yajun Tang
- Regeneron Pharmaceuticals, Tarrytown, NY 10591, USA
| | | | - Neal S Peachey
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH 44195, USA.,Louis Stokes Cleveland VA Medical Center, Cleveland, OH 44106, USA.,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH 44195, USA
| | - Botir T Sagdullaev
- Burke Neurological Institute at Weill Cornell Medicine, White Plains, NY 10605, USA
| | | |
Collapse
|
5
|
Zhou TE, Zhu T, Rivera JC, Omri S, Tahiri H, Lahaie I, Rouget R, Wirth M, Nattel S, Lodygensky G, Ferbeyre G, Nezhady M, Desjarlais M, Hamel P, Chemtob S. The Inability of the Choroid to Revascularize in Oxygen-Induced Retinopathy Results from Increased p53/miR-Let-7b Activity. THE AMERICAN JOURNAL OF PATHOLOGY 2019; 189:2340-2356. [PMID: 31430465 DOI: 10.1016/j.ajpath.2019.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 07/13/2019] [Accepted: 07/26/2019] [Indexed: 12/18/2022]
Abstract
Retinopathy of prematurity (ROP) is characterized by an initial retinal avascularization, followed by pathologic neovascularization. Recently, choroidal thinning has also been detected in children formerly diagnosed with ROP; a similar sustained choroidal thinning is observed in ROP models. But the mechanism underlying the lack of choroidal revascularization remains unclear and was investigated in an oxygen-induced retinopathy (OIR) model. In OIR, evidence of senescence was detected, preceded by oxidative stress in the choroid and the retinal pigment epithelium. This was associated with a global reduction of proangiogenic factors, including insulin-like growth factor 1 receptor (Igf1R). Coincidentally, tumor suppressor p53 was highly expressed in the OIR retinae. Curtailing p53 activity resulted in reversal of senescence, normalization of Igf1r expression, and preservation of choroidal integrity. OIR-induced down-regulation of Igf1r was mediated at least partly by miR-let-7b as i) let-7b expression was augmented throughout and beyond the period of oxygen exposure, ii) let-7b directly targeted Igf1r mRNA, and iii) p53 knock-down blunted let-7b expression, restored Igf1r expression, and elicited choroidal revascularization. Finally, restoration of Igf1r expression rescued choroid thickness. Altogether, this study uncovers a significant mechanism for defective choroidal revascularization in OIR, revealing a new role for p53/let-7b/IGF-1R axis in the retina. Future investigations on this (and connected) pathway could further our understanding of other degenerative choroidopathies, such as geographic atrophy.
Collapse
Affiliation(s)
- Tianwei E Zhou
- Department of Pharmacology and Therapeutics, McGill University, Montréal, Québec, Canada; Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal, Montréal, Québec, Canada.
| | - Tang Zhu
- Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, Université de Montréal, Montréal, Québec, Canada
| | - José C Rivera
- Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal, Montréal, Québec, Canada; Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology, Centre Hospitalier Universitaire Sainte-Justine Hospital, Université de Montréal, Montréal, Québec, Canada
| | - Samy Omri
- Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal, Montréal, Québec, Canada
| | - Houda Tahiri
- Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal, Montréal, Québec, Canada
| | - Isabelle Lahaie
- Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal, Montréal, Québec, Canada
| | - Raphaël Rouget
- Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, Université de Montréal, Montréal, Québec, Canada
| | - Maëlle Wirth
- Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal, Montréal, Québec, Canada
| | - Stanley Nattel
- Department of Pharmacology and Therapeutics, McGill University, Montréal, Québec, Canada; Department of Medicine, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada
| | - Gregory Lodygensky
- Department of Pediatrics, Sainte-Justine University Hospital Centre, Université de Montréal, Montréal, Québec, Canada
| | - Gerardo Ferbeyre
- Department of Biochemistry, Université de Montréal, Montréal, Québec, Canada
| | - Mohammad Nezhady
- Department of Pathology and Cell Biology, University of Montréal, Montréal, Québec, Canada
| | - Michel Desjarlais
- Department of Pharmacology and Therapeutics, McGill University, Montréal, Québec, Canada; Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal, Montréal, Québec, Canada
| | - Patrick Hamel
- Department of Ophthalmology, Centre Hospitalier Universitaire Sainte-Justine Hospital, Université de Montréal, Montréal, Québec, Canada
| | - Sylvain Chemtob
- Department of Pharmacology and Therapeutics, McGill University, Montréal, Québec, Canada; Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, Université de Montréal, Montréal, Québec, Canada; Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, Université de Montréal, Montréal, Québec, Canada; Department of Ophthalmology, Centre Hospitalier Universitaire Sainte-Justine Hospital, Université de Montréal, Montréal, Québec, Canada; Department of Pediatrics, Sainte-Justine University Hospital Centre, Université de Montréal, Montréal, Québec, Canada.
| |
Collapse
|
6
|
Bowl W, Lorenz B, Stieger K, Schweinfurth S, Holve K, Andrassi-Darida M. Fundus-Controlled Dark Adaptometry in Young Children Without and With Spontaneously Regressed Retinopathy of Prematurity. Transl Vis Sci Technol 2019; 8:62. [PMID: 31293816 PMCID: PMC6602151 DOI: 10.1167/tvst.8.3.62] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 03/20/2019] [Indexed: 02/01/2023] Open
Abstract
Purpose We correlate dark adaptation course with foveal morphologic alterations in preterm and term-born children using a modified fundus-controlled perimeter and spectral domain–optical coherence tomography (SD-OCT) imaging. Methods We performed fundus-controlled chromatic dark adaptometry in premature children aged 6 to 13 years without retinopathy of prematurity (no-ROP; n = 61) and with spontaneously regressed ROP (sr-ROP, n = 29), and in 11 age-matched term-born children. The degree of macular developmental arrest (MDA), defined as a disproportion of the outer nuclear layer to inner retinal layers in the fovea (ONL+/IRL-ratio), was analyzed with the DiOCTA tool in SD-OCT scans. Results Children with MDA showed a flatter dark adaptation course progression with a significant rod-mediated sensitivity recovery delay (0.0113 vs. 0.0253 dB/s; P < 0.001). Preterm-born children with regular foveal morphology reached the final rod-mediated dark-adapted threshold at 12 minutes after bleach at 18.8 dB, compared to after 18.7 minutes at 17.6 dB in children with MDA (no significant difference in final threshold; P = 0.773). The cone-mediated dark adaptation progression showed a significant lower final threshold in children with MDA (6.0 vs. 8.1 dB; P = 0.004). Conclusions Changes in dark adaptation were seen in the presence of MDA observed in premature children in the no-ROP and sr-ROP groups. MDA in former premature children is associated with functional deficits of cone and rod photoreceptor visual pathways. Translational Relevance Morphologic alterations in the central retina of premature children, evident in SD-OCT, are associated with long-term functional deficits in the rod and cone pathways, particularly evident in the rod dark adaptation course measured at 12° eccentricity. This indicates a more widespread retinal functional pathology not limited to the fovea, but occurring together with foveal alterations best defined as MDA.
Collapse
Affiliation(s)
- Wadim Bowl
- Department of Ophthalmology, Justus-Liebig-University, Giessen, Germany
| | - Birgit Lorenz
- Department of Ophthalmology, Justus-Liebig-University, Giessen, Germany
| | - Knut Stieger
- Department of Ophthalmology, Justus-Liebig-University, Giessen, Germany
| | | | - Kerstin Holve
- Department of Ophthalmology, Justus-Liebig-University, Giessen, Germany
| | | |
Collapse
|
7
|
Hansen RM, Moskowitz A, Bush JN, Fulton AB. Increment Threshold Functions in Retinopathy of Prematurity. Invest Ophthalmol Vis Sci 2017; 57:2421-7. [PMID: 27145476 PMCID: PMC5113985 DOI: 10.1167/iovs.16-19294] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To assess scotopic background adaptation in subjects with a history of preterm birth and retinopathy of prematurity (ROP). Retinopathy of prematurity is known to have long-term effects on rod photoreceptor and rod mediated postreceptor retinal function. METHODS Rod-mediated thresholds for detection of 3° diameter, 50 ms stimuli presented 20° from fixation were measured using a spatial forced choice method in 36 subjects (aged 9-17 years) with a history of preterm birth and 11 age similar term-born subjects. Thresholds were measured first in the dark-adapted condition and then in the presence of 6 steady background lights (-2.8 to +2.0 log scot td). A model of the increment threshold function was fit to each subject's thresholds to estimate the dark-adapted threshold (TDA) and the Eigengrau (A0, the background that elevates threshold 0.3 log unit above TDA). RESULTS In subjects with a history of severe ROP, both TDA and A0 were significantly elevated relative to those in former preterms who never had ROP and term-born control subjects. Subjects who had mild ROP had normal TDA but elevated A0. Neither TDA nor A0 differed significantly between former preterms who never had ROP and term-born controls. CONCLUSIONS The results suggest that in severe ROP, threshold is affected at a preadaptation site, possibly the rod outer segment. In mild ROP, changes in the Eigengrau may reflect increased intrinsic noise in the photoreceptor or postreceptor circuitry or both.
Collapse
|
8
|
Hansen RM, Moskowitz A, Akula JD, Fulton AB. The neural retina in retinopathy of prematurity. Prog Retin Eye Res 2017; 56:32-57. [PMID: 27671171 PMCID: PMC5237602 DOI: 10.1016/j.preteyeres.2016.09.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/15/2016] [Accepted: 09/20/2016] [Indexed: 12/26/2022]
Abstract
Retinopathy of prematurity (ROP) is a neurovascular disease that affects prematurely born infants and is known to have significant long term effects on vision. We conducted the studies described herein not only to learn more about vision but also about the pathogenesis of ROP. The coincidence of ROP onset and rapid developmental elongation of the rod photoreceptor outer segments motivated us to consider the role of the rods in this disease. We used noninvasive electroretinographic (ERG), psychophysical, and retinal imaging procedures to study the function and structure of the neurosensory retina. Rod photoreceptor and post-receptor responses are significantly altered years after the preterm days during which ROP is an active disease. The alterations include persistent rod dysfunction, and evidence of compensatory remodeling of the post-receptor retina is found in ERG responses to full-field stimuli and in psychophysical thresholds that probe small retinal regions. In the central retina, both Mild and Severe ROP delay maturation of parafoveal scotopic thresholds and are associated with attenuation of cone mediated multifocal ERG responses, significant thickening of post-receptor retinal laminae, and dysmorphic cone photoreceptors. These results have implications for vision and control of eye growth and refractive development and suggest future research directions. These results also lead to a proposal for noninvasive management using light that may add to the currently invasive therapeutic armamentarium against ROP.
Collapse
Affiliation(s)
- Ronald M Hansen
- Department of Ophthalmology, Children's Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115-5737, USA.
| | - Anne Moskowitz
- Department of Ophthalmology, Children's Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115-5737, USA.
| | - James D Akula
- Department of Ophthalmology, Children's Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115-5737, USA.
| | - Anne B Fulton
- Department of Ophthalmology, Children's Hospital and Harvard Medical School, 300 Longwood Ave., Boston, MA 02115-5737, USA.
| |
Collapse
|
9
|
Zhou TE, Rivera JC, Bhosle VK, Lahaie I, Shao Z, Tahiri H, Zhu T, Polosa A, Dorfman A, Beaudry-Richard A, Costantino S, Lodygensky GA, Lachapelle P, Chemtob S. Choroidal Involution Is Associated with a Progressive Degeneration of the Outer Retinal Function in a Model of Retinopathy of Prematurity: Early Role for IL-1β. THE AMERICAN JOURNAL OF PATHOLOGY 2016; 186:3100-3116. [PMID: 27768863 DOI: 10.1016/j.ajpath.2016.08.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 08/05/2016] [Accepted: 08/10/2016] [Indexed: 11/25/2022]
Abstract
Retinopathy of prematurity (ROP), the most common cause of blindness in premature infants, has long been associated with inner retinal alterations. However, recent studies reveal outer retinal dysfunctions in patients formerly afflicted with ROP. We have recently demonstrated that choroidal involution occurs early in retinopathy. Herein, we investigated the mechanisms underlying the choroidal involution and its long-term impact on retinal function. An oxygen-induced retinopathy (OIR) model was used. In vitro and ex vivo assays were applied to evaluate cytotoxic effects of IL-1β on choroidal endothelium. Electroretinogram was used to evaluate visual function. We found that proinflammatory IL-1β was markedly increased in retinal pigment epithelium (RPE)/choroid and positively correlated with choroidal degeneration in the early stages of retinopathy. IL-1β was found to be cytotoxic to choroid in vitro, ex vivo, and in vivo. Long-term effects on choroidal involution included a hypoxic outer neuroretina, associated with a progressive loss of RPE and photoreceptors, and visual deterioration. Early inhibition of IL-1β receptor preserved choroid, decreased subretinal hypoxia, and prevented RPE/photoreceptor death, resulting in life-long improved visual function in IL-1 receptor antagonist-treated OIR animals. Together, these findings suggest a critical role for IL-1β-induced choroidal degeneration in outer retinal dysfunction. Neonatal therapy using IL-1 receptor antagonist preserves choroid and prevents protracted outer neuroretinal anomalies in OIR, suggesting IL-1β as a potential therapeutic target in ROP.
Collapse
Affiliation(s)
- Tianwei E Zhou
- Department of Pharmacology and Therapeutics, McGill University, Montréal, Québec, Canada; Department of Ophthalmology, Hôpital Maisonneuve-Rosemont Research Centre, Université de Montréal, Montréal, Québec, Canada
| | - José C Rivera
- Department of Ophthalmology, Hôpital Maisonneuve-Rosemont Research Centre, Université de Montréal, Montréal, Québec, Canada; Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada
| | - Vikrant K Bhosle
- Department of Pharmacology and Therapeutics, McGill University, Montréal, Québec, Canada; Department of Ophthalmology, Hôpital Maisonneuve-Rosemont Research Centre, Université de Montréal, Montréal, Québec, Canada; Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada
| | - Isabelle Lahaie
- Department of Ophthalmology, Hôpital Maisonneuve-Rosemont Research Centre, Université de Montréal, Montréal, Québec, Canada; Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada
| | - Zhuo Shao
- Department of Pharmacology and Therapeutics, McGill University, Montréal, Québec, Canada; Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada
| | - Houda Tahiri
- Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada
| | - Tang Zhu
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada
| | - Anna Polosa
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada; Department of Ophthalmology, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Allison Dorfman
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada; Department of Ophthalmology, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Alexandra Beaudry-Richard
- Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada
| | - Santiago Costantino
- Department of Ophthalmology, Hôpital Maisonneuve-Rosemont Research Centre, Université de Montréal, Montréal, Québec, Canada
| | - Gregory A Lodygensky
- Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada
| | - Pierre Lachapelle
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada; Department of Ophthalmology, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Sylvain Chemtob
- Department of Pharmacology and Therapeutics, McGill University, Montréal, Québec, Canada; Department of Ophthalmology, Hôpital Maisonneuve-Rosemont Research Centre, Université de Montréal, Montréal, Québec, Canada; Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada; Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada; Department of Ophthalmology, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada.
| |
Collapse
|
10
|
Ramamirtham R, Akula JD, Soni G, Swanson MJ, Bush JN, Moskowitz A, Swanson EA, Favazza TL, Tavormina JL, Mujat M, Ferguson RD, Hansen RM, Fulton AB. Extrafoveal Cone Packing in Eyes With a History of Retinopathy of Prematurity. Invest Ophthalmol Vis Sci 2016; 57:467-75. [PMID: 26868749 PMCID: PMC4758295 DOI: 10.1167/iovs.15-17783] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Purpose To study the density and packing geometry of the extrafoveal cone photoreceptors in eyes with a history of retinopathy of prematurity (ROP). We used a multimodal combination of adaptive optics (AO) scanning light ophthalmoscopy (SLO) and optical coherence tomography (OCT). Methods Cones were identified in subjects (aged 14–26 years) with a history of ROP that was either severe and treated by laser ablation of avascular peripheral retina (TROP; n = 5) or mild and spontaneously resolved, untreated (UROP; n = 5), and in term-born controls (CT; n = 8). The AO-SLO images were obtained at temporal eccentricities 4.5°, 9°, 13.5°, and 18° using both confocal and offset apertures with simultaneous, colocal OCT images. Effects of group, eccentricity, and aperture were evaluated and the modalities compared. Results In the SLO images, cone density was lower and the packing pattern less regular in TROP, relative to CT and UROP retinae. Although SLO image quality appeared lower in TROP, root mean square (RMS) wavefront error did not differ among the groups. In TROP eyes, cone discrimination was easier in offset aperture images. There was no evidence of cone loss in the TROP OCT images. Conclusions Low cone density in TROP confocal SLO images may have resulted from lower image quality. Since AO correction in these eyes was equivalent to that of the control group, and OCT imaging showed no significant cone loss, the optical properties of the inner retina or properties of the cones themselves are likely altered in a way that affects photoreceptor imaging.
Collapse
Affiliation(s)
- Ramkumar Ramamirtham
- Boston Children's Hospital, Boston, Massachusetts, United States 2Harvard Medical School, Boston, Massachusetts, United States
| | - James D Akula
- Boston Children's Hospital, Boston, Massachusetts, United States 2Harvard Medical School, Boston, Massachusetts, United States
| | - Garima Soni
- Boston Children's Hospital, Boston, Massachusetts, United States 3Northeastern University, Boston, Massachusetts, United States
| | - Matthew J Swanson
- Boston Children's Hospital, Boston, Massachusetts, United States 4Air Force Academy, Colorado, United States
| | - Jennifer N Bush
- Boston Children's Hospital, Boston, Massachusetts, United States
| | - Anne Moskowitz
- Boston Children's Hospital, Boston, Massachusetts, United States 2Harvard Medical School, Boston, Massachusetts, United States
| | - Emily A Swanson
- Boston Children's Hospital, Boston, Massachusetts, United States
| | - Tara L Favazza
- Boston Children's Hospital, Boston, Massachusetts, United States
| | - Jena L Tavormina
- Boston Children's Hospital, Boston, Massachusetts, United States
| | - Mircea Mujat
- Physical Sciences, Inc., Andover, Massachusetts, United States
| | | | - Ronald M Hansen
- Boston Children's Hospital, Boston, Massachusetts, United States 2Harvard Medical School, Boston, Massachusetts, United States
| | - Anne B Fulton
- Boston Children's Hospital, Boston, Massachusetts, United States 2Harvard Medical School, Boston, Massachusetts, United States
| |
Collapse
|
11
|
Moskowitz A, Hansen RM, Fulton AB. Retinal, visual, and refractive development in retinopathy of prematurity. Eye Brain 2016; 8:103-111. [PMID: 28539805 PMCID: PMC5398748 DOI: 10.2147/eb.s95021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
The pivotal role of the neurosensory retina in retinopathy of prematurity (ROP) disease processes has been amply demonstrated in rat models. We have hypothesized that analogous cellular processes are operative in human ROP and have evaluated these presumptions in a series on non-invasive investigations of the photoreceptor and post-receptor peripheral and central retina in infants and children. Key results are slowed kinetics of phototransduction and deficits in photoreceptor sensitivity that persist years after ROP has completely resolved based on clinical criteria. On the other hand, deficits in post-receptor sensitivity are present in infancy regardless of the severity of the ROP but are not present in older children if the ROP was so mild that it never required treatment and resolved without a clinical trace. Accompanying the persistent deficits in photoreceptor sensitivity, there is increased receptive field size and thickening of the post-receptor retinal laminae in the peripheral retina of ROP subjects. In the late maturing central retina, which mediates visual acuity, attenuation of multifocal electroretinogram activity in the post-receptor retina led us to the discovery of a shallow foveal pit and significant thickening of the post-receptor retinal laminae in the macular region; this is most likely due to failure of the normal centrifugal movement of the post-receptor cells during foveal development. As for refractive development, myopia, at times high, is more common in ROP subjects than in control subjects, in accord with refractive findings in other populations of former preterms. This information about the neurosensory retina enhances understanding of vision in patients with a history of ROP, and taken as a whole, raises the possibility that the neurosensory retina is a target for therapeutic intervention.
Collapse
Affiliation(s)
- Anne Moskowitz
- Department of Ophthalmology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Ronald M Hansen
- Department of Ophthalmology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Anne B Fulton
- Department of Ophthalmology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
12
|
Hansen RM, Moskowitz A, Tavormina JL, Bush JN, Soni G, Fulton AB. Temporal summation in children with a history of retinopathy of prematurity. Invest Ophthalmol Vis Sci 2015; 56:914-7. [PMID: 25604681 DOI: 10.1167/iovs.14-16102] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To assess temporal summation in children with a history of retinopathy of prematurity (ROP) by determining the critical duration (tCRIT) for complete temporal summation under rod-mediated conditions. From prior ERG studies, it is known that the kinetics of activation of phototransduction are prolonged in the ROP rod photoreceptor. METHODS Dark-adapted thresholds for detecting 10° diameter stimuli with durations from 10 to 640 ms were measured. A two-alternative, spatial, forced-choice psychophysical procedure was used. The tCRIT for complete summation was estimated in former preterm subjects with a history of severe ROP (n = 7), mild ROP (n = 23), and no ROP (n = 15). The subjects ranged in age from 10.4 to 17.6 (median 15.6) years. Age-similar term-born control subjects (n = 5) were also tested. RESULTS Critical duration was significantly longer in subjects with a history of ROP than in subjects who never had ROP or who were born at term. Mean tCRIT in the mild ROP group [127.5 (SD = 19.9) ms] and severe group [147.6 (SD = 18.9) ms] did not differ significantly, but both were significantly longer than in former preterms who never had ROP [101.1 (SD = 16.5) ms] and in term-born controls [101.0 (SD = 19.5) ms]. CONCLUSIONS In ROP subjects, tCRIT is significantly prolonged. This is likely due to abnormal kinetics in the rod outer segment.
Collapse
Affiliation(s)
- Ronald M Hansen
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Anne Moskowitz
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Jena L Tavormina
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Jennifer N Bush
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Garima Soni
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Anne B Fulton
- Department of Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| |
Collapse
|