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Liu E, Tamplin MR, Rosius J, Tedeschi TR, Gramlich OW, Kardon RH, Grumbach IM. Mouse model of radiation retinopathy reveals vascular and neuronal injury. Exp Eye Res 2024; 238:109729. [PMID: 38052338 PMCID: PMC11218432 DOI: 10.1016/j.exer.2023.109729] [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: 02/24/2023] [Revised: 10/09/2023] [Accepted: 11/17/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE To characterize the neuronal and vascular pathology in vivo and in vitro in a mouse model of radiation retinopathy. METHODS C57Bl/6J mice underwent cranial irradiation with 12 Gy and in vivo imaging by optical coherence tomography and of relative blood flow velocity by laser speckle flowgraphy for up to 3-6 months after irradiation. Retinal architecture, vascular density and leakage and apoptosis were analyzed by histology and immunohistochemistry before irradiation or at 10, 30, 240, and 365 days after treatment. RESULTS The vascular density decreased in the plexiform layers starting at 30 days after irradiation. No impairment in retinal flow velocity was seen. Subtle perivascular leakage was present at 10 days, in particular in the outer plexiform layer. This corresponded to increased width of this layer. However, no significant change in the retinal thickness was detected by OCT-B scans. At 365 days after irradiation, the nuclear density was significantly reduced compared to baseline. Apoptosis was detected at 30 days and less prominent at 365 days. CONCLUSIONS By histology, vascular leakage at 10 days was followed by increased neuronal apoptosis and loss of neuronal and vascular density. However, in vivo imaging approaches that are commonly used in human patients did not detect pathology in mice.
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Affiliation(s)
- Emily Liu
- Division of Cardiovascular Medicine, Abboud Cardiovascular Research Center, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Michelle R Tamplin
- Division of Cardiovascular Medicine, Abboud Cardiovascular Research Center, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA; Iowa City VA Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA
| | - Jurnie Rosius
- Division of Cardiovascular Medicine, Abboud Cardiovascular Research Center, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Thomas R Tedeschi
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
| | - Oliver W Gramlich
- Iowa City VA Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA; Department of Neuroscience and Pharmacology, University of Iowa, Iowa City, IA, USA
| | - Randy H Kardon
- Iowa City VA Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA; Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
| | - Isabella M Grumbach
- Division of Cardiovascular Medicine, Abboud Cardiovascular Research Center, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Radiation Oncology, University of Iowa, Iowa City, IA, USA; Iowa City VA Center for the Prevention and Treatment of Visual Loss, Iowa City, IA, USA.
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Ramos MS, Echegaray JJ, Kuhn-Asif S, Wilkinson A, Yuan A, Singh AD, Browne AW. Animal models of radiation retinopathy - From teletherapy to brachytherapy. Exp Eye Res 2019; 181:240-251. [PMID: 30716328 DOI: 10.1016/j.exer.2019.01.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 01/09/2019] [Accepted: 01/30/2019] [Indexed: 12/20/2022]
Abstract
Radiation retinopathy is a serious vision-impairing complication of radiation therapy used to treat ocular tumors. Characterized by retinal vasculopathy and subsequent retinal damage, the first sign of radiation retinopathy is the preferential loss of vascular endothelial cells. Ensuing ischemia leads to retinal degradation and late stage neovascularization. Despite the established disease progression, the pathophysiology and cellular mechanisms contributing to radiation retinopathy remain unclear. Clinical experience and basic research for other retinal vasculopathies, such as diabetic retinopathy and retinopathy of prematurity, can inform our understanding of radiation retinopathy; however, the literature investigating the fundamental mechanisms in radiation retinopathy is limited. Treatment trials have shown modest success but, ultimately, fail to address the cellular events that initiate radiation retinopathy. Animal models of radiation retinopathy could provide means to identify effective therapies. Here, we review the literature for all animal models of radiation retinopathy, summarize anatomical highlights pertaining to animal models, identify additional physiological factors to consider when investigating radiation retinopathy, and explore the use of clinically relevant tests for studying in vivo models of radiation retinopathy. We encourage further investigation into the mechanistic characterization of radiation retinopathy in the hope of discovering novel treatments.
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Affiliation(s)
- Michael S Ramos
- Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Jose J Echegaray
- Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Sonia Kuhn-Asif
- Animal Eye Center, 2864 Acton Road, Birmingham, AL, 35243, UK
| | - Allan Wilkinson
- Taussig Cancer Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Alex Yuan
- Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Arun D Singh
- Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44131, USA
| | - Andrew W Browne
- Gavin Herbert Eye Institute, 850 Health Sciences Road, Irvine, CA, 92697, USA.
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Brachytherapy in Neovascular AMD. CURRENT OPHTHALMOLOGY REPORTS 2015. [DOI: 10.1007/s40135-014-0061-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Morales-Canton V, Quiroz-Mercado H, Velez-Montoya R, Zavala-Ayala A, Moshfeghi AA, Shusterman EM, Kaiser PK, Sanislo SR, Gertner M, Moshfeghi DM. 16 and 24 Gy low-voltage X-ray irradiation with ranibizumab therapy for neovascular age-related macular degeneration: 12-month outcomes. Am J Ophthalmol 2013; 155:1000-1008.e2. [PMID: 23497847 DOI: 10.1016/j.ajo.2013.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Revised: 01/06/2013] [Accepted: 01/08/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe the 12-month safety and efficacy outcomes of 16 or 24 Gy radiation using low-voltage x-ray irradiation in conjunction with intravitreal ranibizumab for neovascular age-related macular degeneration (AMD). DESIGN Prospective, phase I, open-label, nonrandomized uncontrolled safety study. METHODS setting: Institutional. study population: Neovascular AMD patients. intervention: One x-ray irradiation treatment at 16 or 24 Gy was administered externally through 3 locations in the inferior pars plana. After 2 initial monthly loading doses of ranibizumab, subsequent ranibizumab was administered according to predetermined criteria. main outcome measures: Visual acuity, number of ranibizumab injections, safety and efficacy metrics at 12 months. RESULTS Forty-seven eyes of 47 patients were enrolled and completed 12 months of follow-up: 16 Gy (n = 28) and 24 Gy (n = 19). There was no evidence of radiation retinopathy, optic neuropathy, or cataract. The mean visual acuity improved in both groups: +8.4 ± 11.9 letters and +7.8 ± 12 letters for 16 and 24 Gy, respectively. In both groups, 100% of subjects lost <15 letters, with 76% and 79% gaining ≥0 letters in the 16 Gy and 24 Gy groups, respectively. Patients received a mean of 1.0 additional injection over 12 months. The mean change in optical coherence tomography central subfield thickness from baseline to month 12 was -107 and -87 μm for the 16 Gy and 24 Gy groups, respectively. CONCLUSION One treatment of 16 or 24 Gy low-voltage x-ray therapy with as-needed ranibizumab appears safe in subjects with neovascular AMD at 12 months. An overall improvement in visual acuity was observed. No radiation-related adverse effects were reported.
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