1. A nonhuman primate model of blue light-induced progressive outer retina degeneration showing brimonidine drug delivery system-mediated cyto- and neuroprotection
- Author
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Corine Ghosn, Ashutosh Kulkarni, Lakshmi Rajagopalan, Alexandra Almazan, J. E. Burke, Michael Engles, Lori-Ann Christie, Francisco J. López, Lydia Andrews-Jones, and Mitalee Tamhane
- Subjects
0301 basic medicine ,Retinal degeneration ,medicine.medical_specialty ,genetic structures ,Fundus Oculi ,Visual Acuity ,Retinal Pigment Epithelium ,Lesion ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Atrophy ,Drug Delivery Systems ,Ophthalmology ,Geographic Atrophy ,Adrenergic alpha-2 Receptor Agonists ,Electroretinography ,Medicine ,Animals ,Fluorescein Angiography ,Outer nuclear layer ,Retina ,Retinal pigment epithelium ,business.industry ,Choroid ,Brimonidine ,Macular degeneration ,medicine.disease ,Retinal Photoreceptor Cell Outer Segment ,eye diseases ,Sensory Systems ,Neuroprotection ,Disease Models, Animal ,Macaca fascicularis ,030104 developmental biology ,medicine.anatomical_structure ,Cytoprotection ,Brimonidine Tartrate ,030221 ophthalmology & optometry ,sense organs ,medicine.symptom ,Ophthalmic Solutions ,business ,Tomography, Optical Coherence ,medicine.drug - Abstract
Geographic atrophy (GA) is an advanced form of age-related macular degeneration (AMD) characterized by atrophy of the retinal pigment epithelium (RPE), loss of photoreceptors, and disruption of choriocapillaris. Excessive light exposure is toxic to the retina and is a known risk factor for AMD. We first investigated the effects of blue light-induced phototoxicity on RPE and photoreceptors in nonhuman primates (NHPs, a model of progressive retinal degeneration) and then evaluated the potential cyto- and neuroprotective effects of the brimonidine drug delivery system (Brimo DDS). In the first set of experiments related to model development, parafoveal lesions of varying severity were induced using blue light irradiation of the retina of cynomolgus monkeys to evaluate the level of phototoxicity in the RPE and photoreceptors. RPE damage was assessed using fundus autofluorescence imaging to quantify areas of hypofluorescence, while thinning of the outer nuclear layer (ONL, photoreceptor nuclei) was quantified using optical coherence tomography (OCT). Photoreceptor function was assessed using multifocal electroretinography (mfERG). RPE damage progressively increased across all lesion severities from 2 to 12 weeks, as did the extent of ONL thinning. Lesions of high severity continued to show reduction in mfERG amplitude, reaching a statistically significant maximum reduction at 12 weeks. Collectively, the first set of experiments showed that blue light irradiation of the NHP eye resulted in progressive retinal degeneration identified by damage to RPE, ONL thinning, and disrupted photoreceptor function - hallmarks of GA in humans. We then used the model to evaluate the cyto- and neuroprotective effects of Brimo DDS, administered as a therapeutic after allowing the lesions to develop for 5 weeks. Placebo DDS or Brimo DDS were administered intravitreally and a set of untreated animals were used as an additional control. In the placebo DDS group, hypofluorescence area continued to increase from baseline, indicating progressive RPE damage, while progression was significantly slowed in eyes receiving Brimo DDS. Likewise, ONL thinning continued to progress over time in eyes that received the placebo DDS, but was reduced in Brimo DDS-treated eyes. Pharmacologically relevant brimonidine concentrations were sustained in the retina for up to 26 weeks following Brimo DDS administration. In summary, Brimo DDS demonstrated cyto- and neuroprotective effects in a novel NHP GA model of progressive retinal degeneration.
- Published
- 2021