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Peterson SL, Krishnan A, Patel D, Khanehzar A, Lad A, Shaughnessy J, Ram S, Callanan D, Kunimoto D, Genead MA, Tolentino MJ. PolySialic Acid Nanoparticles Actuate Complement-Factor-H-Mediated Inhibition of the Alternative Complement Pathway: A Safer Potential Therapy for Age-Related Macular Degeneration. Pharmaceuticals (Basel) 2024; 17:517. [PMID: 38675477 PMCID: PMC11053938 DOI: 10.3390/ph17040517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
The alternative pathway of the complement system is implicated in the etiology of age-related macular degeneration (AMD). Complement depletion with pegcetacoplan and avacincaptad pegol are FDA-approved treatments for geographic atrophy in AMD that, while effective, have clinically observed risks of choroidal neovascular (CNV) conversion, optic neuritis, and retinal vasculitis, leaving room for other equally efficacious but safer therapeutics, including Poly Sialic acid (PSA) nanoparticle (PolySia-NP)-actuated complement factor H (CFH) alternative pathway inhibition. Our previous paper demonstrated that PolySia-NP inhibits pro-inflammatory polarization and cytokine release. Here, we extend these findings by investigating the therapeutic potential of PolySia-NP to attenuate the alternative complement pathway. First, we show that PolySia-NP binds CFH and enhances affinity to C3b. Next, we demonstrate that PolySia-NP treatment of human serum suppresses alternative pathway hemolytic activity and C3b deposition. Further, we show that treating human macrophages with PolySia-NP is non-toxic and reduces markers of complement activity. Finally, we describe PolySia-NP-treatment-induced decreases in neovascularization and inflammatory response in a laser-induced CNV mouse model of neovascular AMD. In conclusion, PolySia-NP suppresses alternative pathway complement activity in human serum, human macrophage, and mouse CNV without increasing neovascularization.
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Affiliation(s)
- Sheri L. Peterson
- Aviceda Therapeutics Inc., Cambridge, MA 02142, USA; (A.K.); (A.L.); (D.C.); (D.K.); (M.A.G.)
| | - Anitha Krishnan
- Aviceda Therapeutics Inc., Cambridge, MA 02142, USA; (A.K.); (A.L.); (D.C.); (D.K.); (M.A.G.)
| | - Diyan Patel
- Aviceda Therapeutics Inc., Cambridge, MA 02142, USA; (A.K.); (A.L.); (D.C.); (D.K.); (M.A.G.)
| | - Ali Khanehzar
- Aviceda Therapeutics Inc., Cambridge, MA 02142, USA; (A.K.); (A.L.); (D.C.); (D.K.); (M.A.G.)
| | - Amit Lad
- Aviceda Therapeutics Inc., Cambridge, MA 02142, USA; (A.K.); (A.L.); (D.C.); (D.K.); (M.A.G.)
| | - Jutamas Shaughnessy
- Division of Infectious Diseases and Immunology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA; (J.S.); (S.R.)
| | - Sanjay Ram
- Division of Infectious Diseases and Immunology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA; (J.S.); (S.R.)
| | - David Callanan
- Aviceda Therapeutics Inc., Cambridge, MA 02142, USA; (A.K.); (A.L.); (D.C.); (D.K.); (M.A.G.)
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Derek Kunimoto
- Aviceda Therapeutics Inc., Cambridge, MA 02142, USA; (A.K.); (A.L.); (D.C.); (D.K.); (M.A.G.)
| | - Mohamed A. Genead
- Aviceda Therapeutics Inc., Cambridge, MA 02142, USA; (A.K.); (A.L.); (D.C.); (D.K.); (M.A.G.)
| | - Michael J. Tolentino
- Aviceda Therapeutics Inc., Cambridge, MA 02142, USA; (A.K.); (A.L.); (D.C.); (D.K.); (M.A.G.)
- Department of Ophthalmology, University of Central Florida School of Medicine, Orlando, FL 32827, USA
- Department of Ophthalmology, Orlando College of Osteopathic Medicine, Orlando, FL 34787, USA
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Krishnan A, Callanan DG, Sendra VG, Lad A, Christian S, Earla R, Khanehzar A, Tolentino AJ, Vailoces VAS, Greene MK, Scott CJ, Kunimoto DY, Hassan TS, Genead MA, Tolentino MJ. Comprehensive Ocular and Systemic Safety Evaluation of Polysialic Acid-Decorated Immune Modulating Therapeutic Nanoparticles (PolySia-NPs) to Support Entry into First-in-Human Clinical Trials. Pharmaceuticals (Basel) 2024; 17:481. [PMID: 38675441 PMCID: PMC11054942 DOI: 10.3390/ph17040481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 03/27/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
An inflammation-resolving polysialic acid-decorated PLGA nanoparticle (PolySia-NP) has been developed to treat geographic atrophy/age-related macular degeneration and other conditions caused by macrophage and complement over-activation. While PolySia-NPs have demonstrated pre-clinical efficacy, this study evaluated its systemic and intraocular safety. PolySia-NPs were evaluated in vitro for mutagenic activity using Salmonella strains and E. coli, with and without metabolic activation; cytotoxicity was evaluated based on its interference with normal mitosis. PolySia-NPs were administered intravenously in CD-1 mice and Sprague Dawley rats and assessed for survival and toxicity. Intravitreal (IVT) administration in Dutch Belted rabbits and non-human primates was assessed for ocular or systemic toxicity. In vitro results indicate that PolySia-NPs did not induce mutagenicity or cytotoxicity. Intravenous administration did not show clastogenic activity, effects on survival, or toxicity. A single intravitreal (IVT) injection and two elevated repeat IVT doses of PolySia-NPs separated by 7 days in rabbits showed no signs of systemic or ocular toxicity. A single IVT inoculation of PolySia-NPs in non-human primates demonstrated no adverse clinical or ophthalmological effects. The demonstration of systemic and ocular safety of PolySia-NPs supports its advancement into human clinical trials as a promising therapeutic approach for systemic and retinal degenerative diseases caused by chronic immune activation.
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Affiliation(s)
- Anitha Krishnan
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
| | - David G. Callanan
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
| | - Victor G. Sendra
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
| | - Amit Lad
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
| | - Sunny Christian
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
| | - Ravinder Earla
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
| | - Ali Khanehzar
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
| | - Andrew J. Tolentino
- Department of Biology, University of California Berkeley, Berkeley, CA 94720, USA;
| | | | - Michelle K. Greene
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
- The Patrick G. Johnston Centre for Cancer Research, School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Christopher J. Scott
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
- The Patrick G. Johnston Centre for Cancer Research, School of Medicine, Dentistry & Biomedical Sciences, Queen’s University Belfast, Belfast BT9 7AE, UK
| | - Derek Y. Kunimoto
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
| | - Tarek S. Hassan
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
- Oakland University William Beaumont School of Medicine, Royal Oaks, MI 48067, USA
| | - Mohamed A. Genead
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
| | - Michael J. Tolentino
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (D.G.C.); (A.L.); (S.C.); (R.E.); (A.K.); (M.K.G.); (C.J.S.); (D.Y.K.); (T.S.H.); (M.A.G.)
- Department of Ophthalmology, University of Central Florida School of Medicine, Orlando, FL 32827, USA
- Department of Ophthalmology, Orlando College of Osteopathic Medicine, Orlando, FL 34787, USA
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Tolentino MJ, Tolentino AJ, Tolentino EM, Krishnan A, Genead MA. Sialic Acid Mimetic Microglial Sialic Acid-Binding Immunoglobulin-like Lectin Agonism: Potential to Restore Retinal Homeostasis and Regain Visual Function in Age-Related Macular Degeneration. Pharmaceuticals (Basel) 2023; 16:1735. [PMID: 38139861 PMCID: PMC10747662 DOI: 10.3390/ph16121735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/29/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
Age-related macular degeneration (AMD), a leading cause of visual loss and dysfunction worldwide, is a disease initiated by genetic polymorphisms that impair the negative regulation of complement. Proteomic investigation points to altered glycosylation and loss of Siglec-mediated glyco-immune checkpoint parainflammatory and inflammatory homeostasis as the main determinant for the vision impairing complications of macular degeneration. The effect of altered glycosylation on microglial maintained retinal para-inflammatory homeostasis and eventual recruitment and polarization of peripheral blood monocyte-derived macrophages (PBMDMs) into the retina can explain the phenotypic variability seen in this clinically heterogenous disease. Restoring glyco-immune checkpoint control with a sialic acid mimetic agonist targeting microglial/macrophage Siglecs to regain retinal para-inflammatory and inflammatory homeostasis is a promising therapeutic that could halt the progression of and improve visual function in all stages of macular degeneration.
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Affiliation(s)
- Michael J. Tolentino
- Department of Ophthalmology, University of Central Florida College of Medicine, Orlando, FL 32827, USA
- Department of Ophthalmology, Orlando College of Osteopathic Medicine, Orlando, FL 34787, USA
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (M.A.G.)
| | - Andrew J. Tolentino
- Department of Biology, University of California Berkeley, Berkeley, CA 94720, USA;
| | | | - Anitha Krishnan
- Aviceda Therapeutics, Cambridge, MA 02142, USA; (A.K.); (M.A.G.)
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Salvatore S, Fishman GA, Genead MA. Treatment of cystic macular lesions in hereditary retinal dystrophies. Surv Ophthalmol 2013; 58:560-84. [DOI: 10.1016/j.survophthal.2012.11.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 11/14/2012] [Accepted: 11/20/2012] [Indexed: 12/25/2022]
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Jivrajka RV, Genead MA, McAnany JJ, Chow CC, Mieler WF. Microperimetric sensitivity in patients on hydroxychloroquine (Plaquenil) therapy. Eye (Lond) 2013; 27:1044-52. [PMID: 23764990 DOI: 10.1038/eye.2013.112] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 04/23/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to measure macular sensitivity using microperimetry in patients on Plaquenil therapy without evidence of retinopathy as assessed by recommended screening standards. METHODS Sixteen patients from a clinical practice treated with 200 or 400 mg/day of Plaquenil for more than 5 years, without visual complaints (visual acuity 20/25 or better), and without a history of diabetes or macular disease were included. Participants underwent a complete ophthalmic examination with spectral-domain optical coherence tomography (SD-OCT), 10-2 Humphrey visual field (HVF), fundus autofluoresecene (FAF), multifocal electroretinography (mfERG), and microperimetry that covered the central 12° of the visual field. Ten age-similar, visually normal subjects served as controls. RESULTS The average age of the study cohort was of 54.5 years, with an average daily Plaquenil dose of 4.00 mg/kg/day (range, 1.77-6.67 mg/kg/day) and an average cumulative dose of 1485 g (range, 256-3650 g). All patients had normal ocular exams, and no evidence of retinopathy based on 10-2 HVF, FAF, mfERG, and SD-OCT. The mean retinal sensitivity by microperimetry was 15.0 dB (OD) and 14.6 dB (OS). The overall mean microperimetry sensitivity of the patients (14.7±1.9 dB) was significantly lower (P<0.001) than that of the controls (16.5±2.1 dB). CONCLUSIONS Patients on Plaquenil without clinical evidence of retinal toxicity can have reduced retinal sensitivity, as assessed by microperimetry. The mean sensitivity difference between the patients and controls suggests that microperimetry can provide important information regarding visual function in patients on Plaquenil therapy.
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Affiliation(s)
- R V Jivrajka
- Department of Ophthalmology and Visual Sciences, University of Illinois Chicago, Chicago, IL, USA
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Salvatore S, Genead MA, Fishman GA. The prevalence of macular cysts in patients with clinical cone-rod dystrophy determined by spectral-domain optical coherence tomography. Ophthalmic Genet 2013; 35:47-50. [PMID: 23758497 DOI: 10.3109/13816810.2013.804095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND To determine the prevalence of macular cysts in patients with clinical cone-rod dystrophy (CORD) using spectral-domain optical coherence tomography (SD-OCT). If macular cysts could be demonstrated in such patients, they might benefit from treatment with a carbonic anhydrase inhibitor that has been shown to be effective for treating macular cysts in various night-blinding disorders. MATERIAL AND METHODS Thirty-six CORD patients underwent a complete ophthalmic examination and an SD-OCT examination using two different systems. The presence of hypo-reflective lacunae was used to determine the presence of macular cysts. RESULTS The patients' mean age was 42.9 ± 19.5 years (range 6-71 years). Mean BCVA was 1.09 ± 0.64 logMAR (range no light perception to 20/25 + 2 in the better-seeing eye). All the 72 eyes studied showed a variable degree of retinal thinning, disruption of what has been referred to as the inner segment ellipsoid and outer nuclear layer (ONL) thinning of the macula. None showed evidence of macular cysts on OCT testing. CONCLUSIONS Although macular cysts are a common feature of various hereditary night-blinding retinal dystrophies, these were not identified in our cohort of CORD patients.
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Affiliation(s)
- Serena Salvatore
- Department of Ophthalmology, University La Sapienza , Polo Pontino , Italy
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McAnany JJ, Alexander KR, Genead MA, Fishman GA. Equivalent intrinsic noise, sampling efficiency, and contrast sensitivity in patients with retinitis pigmentosa. Invest Ophthalmol Vis Sci 2013; 54:3857-62. [PMID: 23661376 DOI: 10.1167/iovs.13-11789] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine the relationships among equivalent intrinsic noise (Neq), sampling efficiency, and contrast sensitivity (CS) in patients with retinitis pigmentosa (RP), where Neq is an estimate of the amount of noise within the visual pathway and sampling efficiency represents the subject's ability to use stimulus information optimally. METHODS Participants included 10 patients with RP aged 10 to 54 years, who had visual acuities of 20/40 or better, and 10 visually normal control subjects aged 22 to 65 years. CS was measured for 2-cycles-per-degree Gabor patch targets presented in the absence of noise (CS0) and in five levels of noise spectral density. Data were fit with a standard linear amplifier model, which provided estimates of Neq and sampling efficiency. RESULTS CS0 for the patients ranged from normal to as much as a factor of 3 below the lower limit of normal. All 10 patients had abnormally high Neq, including two patients with normal CS0. In comparison, only two patients had lower-than-normal sampling efficiency, and these two patients also had below-normal CS0. Log CS0 for the patients was correlated significantly with log Neq (r = -0.80, P < 0.05), but not with log efficiency (r = 0.54, P = 0.11). CONCLUSIONS Low CS was associated with elevated intrinsic noise in this group of RP patients, but even patients with normal CS had elevated noise levels. The results suggest that CS measurement in both the presence and absence of luminance noise can provide important information about visual dysfunction in RP patients.
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Affiliation(s)
- J Jason McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA.
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McAnany JJ, Genead MA, Walia S, Drack AV, Stone EM, Koenekoop RK, Traboulsi EI, Smith A, Weleber RG, Jacobson SG, Fishman GA. Visual acuity changes in patients with leber congenital amaurosis and mutations in CEP290. JAMA Ophthalmol 2013; 131:178-82. [PMID: 23411883 DOI: 10.1001/2013.jamaophthalmol.354] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To evaluate changes in visual acuity (VA) over time in patients with Leber congenital amaurosis (LCA) and mutations in the CEP290 gene. METHODS Visual acuity was determined at the initial and most recent visits of 43 patients with LCA and CEP290 mutations. The main outcome measures included the best-corrected VA at the initial and most recent visits, as well as the correlation between age and VA. RESULTS At the initial visit, 14 patients had measurable chart VA in the better-seeing eye, 25 patients had nonmeasurable chart VA, and 4 young patients did not have VA assessed. At the most recent visit, 15 patients had measurable chart VA and 28 had nonmeasurable chart VA. The average interval between the 2 visits was 10.4 years (range, 2-47 years). For patients with measurable chart VA, the median logMAR value at the initial visit (0.75; range, 0.10-2.30) and at the most recent visit (0.70; range, 0.10-2.00) did not differ significantly (P> .05). There was no significant relationship between VA and age. CONCLUSIONS Patients with LCA and CEP290 mutations had a wide spectrum of VA that was not related to age or length of follow-up. Severe VA loss was observed in most, but not all, patients in the first decade. These data will help clinicians provide counseling on VA changes in patients with CEP290 mutations and could be of value for future treatment trials.
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Affiliation(s)
- J Jason McAnany
- Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, USA
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Collison FT, Genead MA, Fishman GA, Stone EM. Resolution of mid-peripheral schisis in x-linked retinoschisis with the use of dorzolamide. Ophthalmic Genet 2013; 35:125-7. [PMID: 23514609 DOI: 10.3109/13816810.2013.779383] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Frederick T Collison
- Pangere Center For Hereditary Retinal Diseases, The Chicago Lighthouse for People Who Are Blind or Visually Impaired , Chicago, IL , USA
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Abràmoff M, Abrams GW, Agarwal A, Ai E, Aiello LM, Aiello LP, Albert DM, Aschbrenner MW, Ávila M, Aylward GW, Bedell M, Belfort R, Bennett J, Bergstrom C, Besirli CG, Bhende PS, Binder S, Bird AC, Blodi BA, Blumenkranz MS, Boldt HC, Bornfeld N, Bottoni F, Boulton ME, Bowne SJ, Brantley MA, Bressler NM, Bressler SB, Bringmann A, Brinton DA, Brown GC, Brown JC, Brunner S, Bush RA, Cao D, Capone A, Carruthers D, Cavallerano JD, Chakravarthy U, Chan CC, Chan W, Charles S, Charteris DG, Chen DF, Chen J, Chen Y, Cheung CYL, Chew EY, Chiang A, Chiang MF, Constable IJ, Coscas G, Cruess AF, Cunningham ET, Curcio CA, Daiger SP, Damato BE, Davis JL, Davis MD, Day S, De Potter P, de Smet MD, Denniston AK, Dhaliwal RS, Ding X, Do DV, Dou G, Dunn WA, Ehlers JP, Engelbert M, Faia LJ, Falsini B, Fawzi AA, Fekrat S, Feldon SE, Fernandes RAB, Ferreyra HA, Ferrington DA, Ferris FL, Finger PT, Fisher SK, Fishman GA, Fleckenstein M, Flynn HW, Fok AC, Foulds WS, Freeman WR, Freton A, Friedlander M, Frishman LJ, Fu AD, Garcia Filho CADA, Garcia-Valenzuela E, Gaudric A, Gayed M, Genead MA, Gerding H, Giani A, Goldberg MF, Gombos DS, Gopal L, Gordon C, Goto H, Gragoudas ES, Grant MB, Green WR, Gregg RG, Gregor Z, Gregori G, Gregory-Evans K, Grob S, Groenewald C, Grossniklaus HE, Grover S, Gullapalli VK, Gupta A, Guthoff RF, Hahn P, Haller JA, Harbour JW, Haritoglou C, Hartnett ME, Hawkins BS, He S, Herwig MC, Heussen FM, Hinton DR, Holz FG, Houston SK, Hui YN, Humayun MS, Ikuno Y, Isaac D, Ishibashi T, Jabs DA, Jaffe GJ, Jampol LM, Joffe L, Johnson M, Johnson MW, Johnson RN, Joussen AM, Julian K, Jumper JM, Kaiser PK, Kampik A, Katamay R, Kay CN, Keane PA, Kenney MC, Khaderi KR, Khodair MA, Kim IK, Kim TW, Kirchhof B, Klein BE, Klein R, Konstantinidis L, Kozak I, Kuppermann BD, Labriola LT, Lai TY, Lam DS, Lam LA, Landers MB, Lane AM, Lavik EB, Leary JF, Lee SY, Lee TC, Leung LSB, Lewis DA, Lewis GP, Leys A, Li X, Liakopoulos S, Lin CP, Lin P, Liu DT, London NJ, Lujan BJ, Luo Y, Lutty GA, MacLaren R, Madreperla S, Maguire AM, Mainster MA, Mansfield NC, Markoe AM, Marmor MF, Martin DF, Massey SC, McCall MA, McCannel TA, McCutchan JA, McDonald HR, Mehta MP, Meier P, Merbs S, Meredith TA, Meyer CH, Mieler WF, Miller JW, Mirza RG, Mitter SK, Mittra RA, Miyake Y, Montemagno C, Moshiri A, Mruthyunjaya P, Muccioli C, Mullins RF, Murata T, Murphree AL, Murphy RP, Murray PI, Murray TG, Nagpal M, Namperumalsamy P, Nanda SK, Nguyen QD, Nussenblatt RB, Oh KT, Ohji M, Ohno-Matsui K, Palanker D, Patel PS, Pavlick AC, Peereboom DM, Pennesi ME, Pepose JS, Perry JD, Puliafito CA, Quiram PA, Raman R, Ramchandran RS, Rao HV, Rao NA, Rao PK, Rathinam SR, Recchia FM, Redmond KJ, Reh TA, Reichenbach A, Ritch R, Rosenfeld PJ, Rubin GS, Ruiz-Garcia H, Ryan SJ, Sadda SR, Sadun AA, Sakamoto T, Sampath AP, Schachat AP, Schmitz-Valckenberg S, Schwartz SG, Scott AW, Sebag J, Seddon JM, Sen HN, Sepah YJ, Sharma S, Sharma T, Sheu SJ, Shields CL, Shields JA, Shinoda K, Shukla D, Sieving PA, Silva PA, Silveira C, Singh AD, Smith SB, Smith WM, Sobrin L, Sodhi A, Sohn EH, Soubrane G, Spielberg L, Srivastava SK, Stachs O, Staurenghi G, Sternberg P, Stone EM, Sugino IK, Sullivan LS, Sullivan P, Sun JK, Sunness JS, Tadayoni R, Tang S, Terasaki H, Thomas MA, Thompson JT, Thumann G, Toth CA, Trese MT, Tsai JH, Turell ME, Turner PL, Udar N, Ulrich JN, Van Gelder RN, van Meurs JC, Vasconcelos-Santos DV, Vavvas DG, Vemulakonda GA, Wang H, Wang Y, Weiland JD, Weleber RG, Wharam MD, Wickham L, Wiedemann P, Wiley HE, Wilkinson C, Wilson DJ, Wolfensberger TJ, Wong D, Wong IY, Wong TY, Wu DM, Yandiev Y, Yang CH, Yang CM, Yannuzzi LA, Yasuda M, Yeh PT, Yehoshua Z, Yiu G, Yoon YH, Yu HG, Yuan A, Zarbin MA, Zhang JJ, Zhang K, Zhao M, Zhou P. Contributors. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00159-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Godara P, Cooper RF, Sergouniotis PI, Diederichs MA, Streb MR, Genead MA, McAnany JJ, Webster AR, Moore AT, Dubis AM, Neitz M, Dubra A, Stone EM, Fishman GA, Han DP, Michaelides M, Carroll J. Assessing retinal structure in complete congenital stationary night blindness and Oguchi disease. Am J Ophthalmol 2012; 154:987-1001.e1. [PMID: 22959359 DOI: 10.1016/j.ajo.2012.06.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 06/09/2012] [Accepted: 06/11/2012] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine retinal structure and changes in photoreceptor intensity after dark adaptation in patients with complete congenital stationary night blindness and Oguchi disease. DESIGN Prospective, observational case series. METHODS We recruited 3 patients with complete congenital stationary night blindness caused by mutations in GRM6, 2 brothers with Oguchi disease caused by mutations in GRK1, and 1 normal control. Retinal thickness was measured from optical coherence tomography images. Integrity of the rod and cone mosaic was assessed using adaptive optics scanning light ophthalmoscopy. We imaged 5 of the patients after a period of dark adaptation and examined layer reflectivity on optical coherence tomography in a patient with Oguchi disease under light- and dark-adapted conditions. RESULTS Retinal thickness was reduced in the parafoveal region in patients with GRM6 mutations as a result of decreased thickness of the inner retinal layers. All patients had normal photoreceptor density at all locations analyzed. On removal from dark adaptation, the intensity of the rods (but not cones) in the patients with Oguchi disease gradually and significantly increased. In 1 Oguchi disease patient, the outer segment layer contrast on optical coherence tomography was 4-fold higher under dark-adapted versus light-adapted conditions. CONCLUSIONS The selective thinning of the inner retinal layers in patients with GRM6 mutations suggests either reduced bipolar or ganglion cell numbers or altered synaptic structure in the inner retina. Our finding that rods, but not cones, change intensity after dark adaptation suggests that fundus changes in Oguchi disease are the result of changes within the rods as opposed to changes at a different retinal locus.
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Affiliation(s)
- Pooja Godara
- Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, WI, USA
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Gowrisankaran S, Genead MA, Anastasakis A, Alexander KR. Characteristics of late negative ERG responses elicited by sawtooth flicker. Doc Ophthalmol 2012; 126:9-19. [PMID: 23054159 DOI: 10.1007/s10633-012-9352-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 09/24/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND This study aimed to determine whether the properties of the late negative responses (LNRs) of the electroretinogram (ERG) elicited by sawtooth flicker are consistent with the characteristics of the photopic negative response generated by a light pulse (PhNRpulse). METHODS ERG recordings were obtained from 10 visually normal individuals and from 6 patients with optic atrophy (OA) in response to 8-Hz rapid-on and rapid-off sawtooth flicker and to brief (4 ms) light pulses. All stimuli were either long wavelength (R), middle wavelength (G), or a combination of equal luminances of long and middle wavelengths (Y) presented on a short-wavelength, rod-saturating adapting field. Amplitudes of LNRs were obtained in response to rapid-on (LNRon) and rapid-off (LNRoff) sawtooth flicker and were also derived from the sum of the ERG waveforms to the two sawtooth phases (LNRadd). RESULTS For the control subjects, PhNRpulse amplitude varied with stimulus wavelength, being largest in response to a long-wavelength pulse, as expected. However, the amplitudes of LNRon, LNRoff, and LNRadd were not significantly different for R, Y, and G sawtooth flicker. Despite the absence of a chromatic effect, LNRoff and LNRadd amplitudes were significantly smaller in the OA patients than in the controls, similar to the results for the PhNRpulse, implying an inner retinal origin for the LNRoff and LNRadd. However, LNRon amplitudes did not differ significantly between the OA patients and controls, although there was a significant correlation between the LNRon and PhNRpulse for R stimuli. CONCLUSION We conclude that LNRoff and LNRadd but not LNRon can be useful measures to assess the integrity of the inner retina that can complement the PhNRpulse.
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Affiliation(s)
- Sowjanya Gowrisankaran
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor St., Chicago, IL 60612, USA
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Genead MA, Fishman GA. Efficacy of brinzolamide ophthalmic suspension 1% for treatment of a vitelliform macular lesion in a patient with desferrioxamine retinopathy. Ophthalmic Surg Lasers Imaging Retina 2011; 42 Online:e114-7. [PMID: 22150599 DOI: 10.3928/15428877-20111201-03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Accepted: 10/30/2011] [Indexed: 11/20/2022]
Abstract
A 46-year-old woman with a vitelliform macular lesion secondary to desferrioxamine retinal toxicity in the right eye was treated with brinzolamide 1% ophthalmic drops three times a day. A spectral-domain optical coherence tomography (SD-OCT) unit was used to monitor any changes in the macular lesion. Two months after starting the eye drops, the SD-OCT showed a notable improvement in the vitelliform macular lesion's thickness. Six months later, further improvement was noted in the macular lesion thickness on SD-OCT testing in the right eye. Best-corrected visual acuity was initially 1.00 logarithm of the minimum angle of resolution (20/200 on a Snellen acuity chart) in the right eye and 0.14 logarithm of the minimum angle of resolution (20/25(-2)) in the left eye. After 6 months of treatment, visual acuity was 0.92 (20/200(+1)) in the right eye and 0.08 (20/25(+1)) in the left eye. The use of brinzolamide 1% was associated with a marked reduction in a vitelliform macular lesion on SD-OCT testing secondary to desferrioxamine retinal toxicity.
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Affiliation(s)
- Mohamed A Genead
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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Genead MA, Fishman GA, Rha J, Dubis AM, Bonci DMO, Dubra A, Stone EM, Neitz M, Carroll J. Photoreceptor structure and function in patients with congenital achromatopsia. Invest Ophthalmol Vis Sci 2011; 52:7298-308. [PMID: 21778272 DOI: 10.1167/iovs.11-7762] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To assess photoreceptor structure and function in patients with congenital achromatopsia. METHODS Twelve patients were enrolled. All patients underwent a complete ocular examination, spectral-domain optical coherence tomography (SD-OCT), full-field electroretinographic (ERG), and color vision testing. Macular microperimetry (MP; in four patients) and adaptive optics (AO) imaging (in nine patients) were also performed. Blood was drawn for screening of disease-causing genetic mutations. RESULTS Mean (± SD) age was 30.8 (± 16.6) years. Mean best-corrected visual acuity was 0.85 (± 0.14) logarithm of the minimal angle of resolution (logMAR) units. Seven patients (58.3%) showed either an absent foveal reflex or nonspecific retinal pigment epithelium mottling to mild hypopigmentary changes on fundus examination. Two patients showed an atrophic-appearing macular lesion. On anomaloscopy, only 5 patients matched over the entire range from 0 to 73. SD-OCT examination showed a disruption or loss of the macular inner/outer segments (IS/OS) junction of the photoreceptors in 10 patients (83.3%). Seven of these patients showed an optically empty space at the level of the photoreceptors in the fovea. AO images of the photoreceptor mosaic were highly variable but significantly disrupted from normal. On ERG testing, 10 patients (83.3%) showed evidence of residual cone responses to a single-flash stimulus response. The macular MP testing showed that the overall mean retinal sensitivity was significantly lower than normal (12.0 vs. 16.9 dB, P < 0.0001). CONCLUSIONS The current approach of using high-resolution techniques to assess photoreceptor structure and function in patients with achromatopsia should be useful in guiding selection of patients for future therapeutic trials as well as monitoring therapeutic response in these trials.
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Affiliation(s)
- Mohamed A Genead
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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Genead MA, McAnany JJ, Fishman GA. Retinal nerve fiber thickness measurements in choroideremia patients with spectral-domain optical coherence tomography. Ophthalmic Genet 2011; 32:101-6. [PMID: 21268676 DOI: 10.3109/13816810.2010.544364] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate the presence of peripapillary retinal nerve fiber layer (RNFL) defects in patients with choroideremia by using spectral-domain optical coherence tomography (SD-OCT). METHODS Twenty-nine eyes of 16 patients with choroideremia underwent peripapillary RNFL thickness measurements by using SD-OCT. RESULTS The mean (±SD) age of the study population was 44.0 ± 16.0 years (range, 13-63 years). Thirteen eyes (45%) showed a thinning of the peripapillary RNFL in at least 1 quadrant in either 1 or both eyes. Thinning was most commonly found in the superior (13 eyes) and inferior (10 eyes) quadrants. Twenty-one eyes (72%) showed a thickening of the peripapillary RNFL in at least 1 quadrant in either 1 or both eyes. Of these 21 eyes, all had thickening in the temporal quadrant. Additionally, 2 eyes in each of the other 3 quadrants were found to be abnormally thick. CONCLUSION Our study demonstrated the presence of defects in the peripapillary RNFL thickness in patients with choroideremia by using SD-OCT. It would be clinically prudent that choroideremia patients considered for various treatment options be considered for RNFL thickness measurements.
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Affiliation(s)
- Mohamed A Genead
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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Genead MA, Fishman GA. Cystic macular oedema on spectral-domain optical coherence tomography in choroideremia patients without cystic changes on fundus examination. Eye (Lond) 2010; 25:84-90. [PMID: 20966974 DOI: 10.1038/eye.2010.157] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To determine the prevalence of cystic macular oedema (CME) in patients with choroideremia (CHM) by using spectral-domain optical coherence tomography (SD-OCT). METHODS A total 16 patients affected with CHM were enrolled in the study. All patients underwent a complete eye examination. SD-OCT was performed using an OPKO spectral-domain OCT/SLO instrument. RESULTS The average age of the study patients was 44.0 ± 16.0 years (range, 13-63 years). Out of the 16 patients with CHM, 10 patients (62.5%) showed a degree of CME on SD-OCT testing in at least one eye, and 8 patients (50%) showed CME in both eyes. CONCLUSIONS Because of its notable prevalence, it would seem prudent to screen CHM patients by SD-OCT for the possible presence of CME and to identify those amenable to future treatment strategies for their macular oedema.
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Affiliation(s)
- M A Genead
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612-7234, USA
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Genead MA, Fishman GA, Anastasakis A. Spectral-domain OCT peripapillary retinal nerve fibre layer thickness measurements in patients with Stargardt disease. Br J Ophthalmol 2010; 95:689-93. [PMID: 20935302 DOI: 10.1136/bjo.2010.189720] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To evaluate the presence of peripapillary retinal nerve fibre layer (RNFL) defects in patients with Stargardt disease by using spectral-domain optical coherence tomography (SD-OCT). METHODS Fifty-two eyes of 27 patients with Stargardt disease underwent peripapillary RNFL thickness measurements using SD-OCT. RESULTS Twenty-seven patients with Stargardt disease were enrolled. Their mean (±SD) age was 38.3 (14.7) years. Fourteen patients (51.9%) showed a thinning of the peripapillary RNFL in one or more quadrants in at least one eye, and four patients (14.8%) in both eyes. Five patients (18.5%) showed a thickening of the peripapillary RNFL in at least one eye, and four patients (14.8%) in both eyes. CONCLUSION This study demonstrated the presence of defects in the peripapillary RNFL thickness in patients with Stargardt disease by using SD-OCT. It would be clinically prudent that Stargardt patients considered for various treatment options be considered for RNFL thickness measurements.
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Affiliation(s)
- Mohamed A Genead
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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Genead MA, Fishman GA. Efficacy of sustained topical dorzolamide therapy for cystic macular lesions in patients with retinitis pigmentosa and usher syndrome. ACTA ACUST UNITED AC 2010; 128:1146-50. [PMID: 20837798 DOI: 10.1001/archophthalmol.2010.172] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To determine the efficacy of sustained topical therapy with dorzolamide hydrochloride, 2%, on visual acuity and cystic macular lesions in patients with retinitis pigmentosa and Usher syndrome. METHODS In a retrospective case series at a university hospital, 64 eyes of 32 patients with retinitis pigmentosa or Usher syndrome receiving treatment with the topical dorzolamide formulation for 6 to 58 months were enrolled. Changes in visual acuity on the Early Treatment Diabetic Retinopathy Study chart and central foveal zone thickness on optical coherence tomography were measured during follow-up for the duration of treatment. RESULTS Among the study cohort, 20 of 32 patients (63%) showed a positive response to treatment in at least 1 eye and 13 patients (41%) showed a positive response in both eyes. Four patients (20%) showed an initial response and a subsequent rebound of macular cysts. In 8 patients (25%), there was no response to treatment and the macular cysts worsened when compared with the pretreatment level. Ten patients (31%) had improvement in visual acuity by 7 or more letters in at least 1 eye at the most recent follow-up visit. Sixteen patients (67%) showed a reduction of more than 11% in the central foveal zone thickness in at least 1 eye when compared with the pretreatment level. CONCLUSIONS Patients with either retinitis pigmentosa or Usher syndrome who received treatment of cystoid macular edema with topical dorzolamide followed by an optical coherence tomography-guided strategy showed a decrease in central foveal zone thickness in most cases. Visual acuity improved in almost one-third of the cases, suggesting a potential corresponding visual benefit.
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Affiliation(s)
- Mohamed A Genead
- Department of Ophthalmology and Visual Sciences, Eye and Ear Infirmary, Chicago, IL 60612-7234, USA
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Genead MA, Fishman GA, McAnany JJ. Efficacy of topical dorzolamide for treatment of cystic macular lesions in a patient with enhanced S-cone syndrome. Doc Ophthalmol 2010; 121:231-40. [PMID: 20842519 DOI: 10.1007/s10633-010-9247-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 08/20/2010] [Indexed: 12/15/2022]
Abstract
The purpose of this study was to evaluate the efficacy of topical dorzolamide 2% eye drops on macular function and thickness in a case of enhanced S-cone syndrome (ESCS). A 24-year-old Asian man with enhanced S-cone syndrome treated with topical dorzolamide in the left eye participated in the study. Examinations performed before and during treatment were included visual acuity (VA), contrast sensitivity measured with briefly presented grating targets (grating CS) and the Pelli-Robson chart (P-R CS), microperimetry (MP), and spectral-domain optical coherence tomography (SD-OCT). Following 4 months of treatment, the mean thickness of the central 1-mm foveal subfield of the left eye, as measured by SD-OCT, decreased from 551 to 242 μm. Mean MP sensitivity within the central 12 degrees (28 points) increased from 9.4 dB at baseline to 11.2 dB. Although Pelli-Robson contrast sensitivity improved only minimally in the left eye, grating contrast sensitivity improved by more than a factor of two. Mean log MAR VA was 0.22 OD and 1.00 OS (at baseline), which improved to 0.10 OD and 0.66 OS after 4 months of treatment. The results indicate that in our patient with enhanced S-cone syndrome, treatment with topical dorzolamide was effective in improving macular thickness, VA, microperimetry sensitivity, and grating contrast sensitivity. These measures of retinal structure and function are sensitive tools for evaluating the effects of treatment in enhanced S-cone syndrome patients with cystoid macular edema. Further investigation is warranted to assess the relationships among visual performance for daily activities, visual sensitivity, and macular thickness.
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Affiliation(s)
- Mohamed A Genead
- Department of Ophthalmology and Visual Sciences (MC 648), University of Illinois at Chicago, Room 3.85, Eye and Ear Infirmary, 1855 W Taylor Street, Chicago, IL 60612-7234, USA
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Genead MA, Fishman GA, Lindeman M. Spectral-domain optical coherence tomography and fundus autofluorescence characteristics in patients with fundus albipunctatus and retinitis punctata albescens. Ophthalmic Genet 2010; 31:66-72. [PMID: 20450307 DOI: 10.3109/13816810903584971] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Fundus albipunctatus is a form of congenital stationary night blindness characterized by an early onset and nonprogressive impairment of night vision and the presence of numerous dull-white punctate lesions scattered throughout the fundus, while retinitis punctata albescens patients often show similar fundus changes but manifest a severe and progressive hereditary retinal dystrophy. CONCLUSIONS In this study, we report the optical coherence tomography and fundus autofluorescence measurements in patients with these hereditary night blinding diseases.
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Affiliation(s)
- Mohamed A Genead
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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Genead MA, Fishman GA, Anastasakis A, Lindeman M. Macular vitelliform lesion in desferrioxamine-related retinopathy. Doc Ophthalmol 2010; 121:161-6. [PMID: 20532952 DOI: 10.1007/s10633-010-9236-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 05/24/2010] [Indexed: 10/19/2022]
Abstract
To report a case of a macular vitelliform lesion associated with desferrioxamine treatment. Ocular, electrophysiological, psychophysical, perimetric, fluorescein angiographic, fundus autofluorescence, and spectral-domain OCT examinations were obtained on a 45-year-old Caucasian woman with thalassemia major treated with blood transfusions and desferrioxamine. The patient was observed to have a vitelliform macular lesion in the right eye with a hypopigmented macular lesion and retinal pigment mottling in the left. At the most recent follow-up visit, best-corrected visual acuity was 20/70 in the right eye and 20/25 in left. Full-field electroretinogram (ERG) testing showed normal cone and rod responses. Mild localized elevations of rod psychophysical thresholds were found. A vitelliform macular lesion can develop in patients treated with desferrioxamine. Some such patients may not show diffuse photoreceptor cell functional loss as determined by electrophysiological testing.
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Affiliation(s)
- Mohamed A Genead
- Department of Ophthalmology and Visual Sciences (MC 648), University of Illinois at Chicago, Room 3.85, Eye and Ear Infirmary, 1855 W Taylor Street, Chicago, IL 60612-7234, USA
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Genead MA. Efficacy of Sustained Topical Dorzolamide Therapy for Cystic Macular Lesions in Patients With X-Linked Retinoschisis. ACTA ACUST UNITED AC 2010; 128:190-7. [DOI: 10.1001/archophthalmol.2009.398] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Genead MA, Fishman GA, Stone EM, Allikmets R. The natural history of stargardt disease with specific sequence mutation in the ABCA4 gene. Invest Ophthalmol Vis Sci 2009; 50:5867-71. [PMID: 19578016 DOI: 10.1167/iovs.09-3611] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine longitudinal changes in fundus appearance and visual function in patients with Stargardt with at least one allelic mutation (Gly1961Glu) in the ABCA4 gene. METHODS Sixteen patients with a diagnosis of Stargardt disease and a Gly1961Glu mutation were enrolled. All patients underwent a complete ocular examination including best corrected visual acuity, Goldmann visual field (GVF), and full-field ERG examinations. The percentage of patients who showed at least a doubling in the log of the minimum angle of visual resolution (logMAR) between their initial and most recent visits was determined, as was the percentage of patients who showed a doubling in the size of the central scotoma over this duration. RESULTS Nine patients had at least a doubling of the logMAR visual acuity in their right eyes and 10 patients in their left eyes, over a mean follow-up (FU) period of 18.6 years. Of 15 patients, 46.7% had equal to or more than a doubling of the central scotoma area in response to a II2e test stimulus in the right eye and 60.0% in the left eyes. Among 10 patients whose ERGs were initially normal for rod and cone responses, 8 remained normal at their most recent FU visit. CONCLUSIONS In these patients with Stargardt disease and a Gly1961Glu mutation, most showed a clinical phenotype characterized by fundus changes localized to the foveal and parafoveal regions, normal ERG amplitudes, absence of a silent or masked choroid, and a mean age at initial presentation in the third decade.
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Affiliation(s)
- Mohamed A Genead
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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Abstract
Purpose 19 To evaluate the presence of retinal nerve fiber layer (RNFL) defects in patients with XLRS using high speed, high resolution, Fourier domain OCT (FD-OCT). Methods Twenty four patients with XLRS seen by the authors were enrolled in the study. All patients underwent a complete eye examination. FD-OCT was performed using Optovue technology. A quadrant of the RNFL was considered to be thinned if at least 2 of the 4 segments in the quadrant were reduced in thickness. Results The average age of the 24 patients in the study was 28.8 years ± 14.7 years. Thinning of the RNFL in 1 quadrant was seen in 10 patients (41.7%), and thinning in 2 or more quadrants was seen in 8 patients (33.3%). Thinning in the inferior quadrant was most commonly seen and was observed in 12 patients (50%), followed by the temporal quadrant in 8 patients (33.3%), nasal quadrant in 4 patients (16.7%), and the superior quadrant in 4 patients (16.7%). Conclusions Among our 24 patients with XLRS, 15 patients (62.5%) showed a thinning of the RNFL in one or more quadrants in at least one eye and 9 patients (37.5%) in both eyes. The use of high speed, high resolution FD-OCT may be useful to determine the presence of possible changes in RNFL thickness in patients with XLRS. Reductions in RNFL thickness in such patients could be relevant in their selection for future therapeutic trials.
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Affiliation(s)
- M A Genead
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA
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