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Biomedical subjects

Radouil Tzekov

Publications and source records attributed to Radouil Tzekov.

5 recordsLinked to original sources

Ocular changes after photodynamic therapy.

PURPOSE: The aim of this study was to identify the changes in the primate visual system after a single session of photodynamic therapy (PDT) in an intact nonhuman primate retina. METHODS: As part of a larger study, PDT (wavelength 689 nm, 50 J/cm2, 600 mW/cm2, 83 seconds, 4-mm spot size) with verteporfin (6 mg/m2 intravenous infusion) was performed in one eye each of two cynomolgus monkeys. Fundus photography, fluorescein angiography (FA), indocyanine green angiography (ICG), optical coherence tomography (OCT), and multifocal electroretinography (mfERG) were performed at baseline and 12 time points (1-283 days) after PDT. In addition, retinal histopathologic findings were evaluated at 9 months. RESULTS: Various morphologic changes, including whitening of the treated area, RPE proliferation, closure of the choroidal vasculature, and subretinal edema (followed by foveolar thinning) were observed. Most of the changes persisted and were detectable in histopathologic evaluation at 9 months. Reductions of the mfERG amplitude, followed by varying degrees of recovery from the treated and the border regions, were observed. This was accompanied by progressive delay of P1 peak time up to 3 months after treatment, followed by complete recovery at 9 months. In addition, the nontreated area showed amplitude and timing mfERG deficits, which underwent gradual (but not complete) recovery. CONCLUSIONS: In a primate model, under standard clinical parameters, a single PDT treatment resulted in various dynamic morphologic and functional retinal changes detectable for up to 9 months after treatment. The significance of the observed changes and possible ways of pharmacologic interference with PDT adverse effects are discussed.

Animals↗

An overview of drug development with special emphasis on the role of visual electrophysiological testing.

Visual electrophysiological techniques, such as electroretinography (ERG) and visual evoked potentials (VEP) can provide useful information on the safety, efficacy, and proper dosing of chemical entities under development as new drug therapies. During post-marketing safety surveillance, a variety of visual electrophysiological measures can be used to objectively assess and document individual patient response to ophthalmic drugs and ocular or visual system side effects of non-ophthalmic drugs. In this paper, the discovery, exploratory development, full-development and post-marketing stages of drug development are briefly outlined. The potential role of visual electrophysiological techniques in each of these stages is described and discussed.

Animals↗

Ocular toxicity due to chloroquine and hydroxychloroquine: electrophysiological and visual function correlates.

Chloroquine (CQ) and hydroxycholorquine (HCQ) have been used widely for the treatment of rheumatoid arthritis and other similar inflammatory diseases since the early 50s. They remain the treatment of choice for many patients even today. Significant, either reversible or irreversible central visual loss associated with the drugs is very rare, but an important side effect that can warrant discontinuation of therapy. Early diagnosis of toxicity and evaluation of the visual function are, therefore, important parts of the treatment process. Various electrophysiological and psychophysical tests have been and are used for the detection, follow-up and prognosis of drug-associated central visual loss. A summary and comment on the tests, with emphasis on the use of more recently developed methods, such as the multifocal electroretinography (mfERG), are presented in this review.

Animals↗

The lens-coating agent and the electroretinogram.

PURPOSE: To investigate the effects of 0.5, 1.0 and 2.5% methylcellulose coating agents on the ERG in normals. METHODS: A total of 15 healthy volunteers underwent photopic ERG recordings in three experimental protocols comparing 0.5, 1.0 and 2.5% methylcellulose solutions. The conductivity of the solutions was measured. RESULTS: The difference between 0.5 and 1.0% solutions showed significant changes (p < 0.05) in ERG amplitudes. The 0.5% solution produced approximately 15% higher ERG amplitudes than the 1.0% solution. Comparison between 1.0 and 2.5% solutions did not show significant changes in ERG amplitudes. The conductivity was essentially the same for 0.5 and 1.0% solutions, but conductivity of the 2.5% solution was roughly half of that of the other two solutions. CONCLUSIONS: Although the 0.5% solution did yield significantly higher ERG values than the 1.0% and 2.5% solutions, the exact mechanism by which this occurs is not known. The source of these differences could arise from a combination of factors such as conductivity, viscosity, or other unknown components of the solutions. ERG laboratories should be consistent in the use of coating agents, and be aware that any change in solution might alter normative values by a modest percentage.

Adult↗

Comparison of conventional ERG parameters and high-intensity A-wave analysis in a clinical setting.

Computational analysis of high-intensity a-waves yields direct information about the rod and cone receptor potential. However, it is not clear whether such information adds materially to the diagnostic value of the standard ERG in a routine clinical setting. We recorded both conventional ISCEV standard and computational high intensity ERG parameters from 38 patients referred to a clinical laboratory for ERG testing, and also from eight normal volunteers. The patients were grouped as: (1) macular dysfunction; (2) diffuse cone dysfunction; (3) diffuse rod-cone dysfunction. The results showed moderate variation in both conventional and computational parameters, but in general a similar pattern of normality or abnormality for both among the disease groups. There were only a few outlying subjects for which one or the other approach seemed more sensitive. We conclude that a-wave analysis is an important tool for clinical research and the study of special patients, but adding it to the standard ERG protocol does not, at our present state of knowledge, add markedly to clinical evaluations in a routine clinical setting.

Adult↗