A single intravitreal injection of ranibizumab provides no neuroprotection in a nonhuman primate model of moderate-to-severe nonarteritic anterior ischemic optic neuropathy

Neil R Miller, Mary A. Johnson, Theresa Nolan, Yan Guo, Steven L. Bernstein

Research output: Contribution to journalArticle

Abstract

PURPOSE. Ranibizumab, a vascular endothelial growth factor-antagonist, is said to be neuroprotective when injected intravitreally in patients with nonarteritic anterior ischemic optic neuropathy (NAION). We evaluated the efficacy of a single intravitreal (IVT) injection of ranibizumab in a nonhuman primate model of NAION (pNAION). METHODS. We induced pNAION in one eye of four adult male rhesus monkeys using a laseractivated rose Bengal induction method. We then immediately injected the eye with either ranibizumab or normal saline (NS) intravitreally. We performed a clinical assessment, optical coherence tomography, electrophysiological testing, fundus photography, and fluorescein angiography in three of the animals (one animal developed significant retinal hemorrhages and, therefore, could not be analyzed completely) prior to induction, 1 day and 1, 2, and 4 weeks thereafter. Following the 4-week analysis of the first eye, we induced pNAION in the contralateral eye and then injected either ranibizumab or NS, whichever substance had not been injected in the first eye. We euthanized all animals 5 to 12 weeks after the final assessment of the second eye and performed both immunohistochemical and light and electron microscopic analyses of the retina and optic nerves of both eyes. RESULTS. A single IVT dose of ranibizumab administered immediately after induction of pNAION resulted in no significant reduction of clinical, electrophysiological, or histologic damage compared with vehicle-injected eyes. CONCLUSIONS. A single IVT dose of ranibizumab is not neuroprotective when administered immediately after induction of pNAION.

Original languageEnglish (US)
Pages (from-to)7676-7685
Number of pages10
JournalInvestigative Ophthalmology and Visual Science
Volume56
Issue number13
DOIs
Publication statusPublished - Dec 1 2015

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Keywords

  • Anterior ischemic optic neuropathy
  • Intravitreal injection
  • Neuroprotection
  • Ranibizumab

ASJC Scopus subject areas

  • Medicine(all)
  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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