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Akula, James

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Akula

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James

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Akula, James

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  • Publication

    The Neurovascular Relation in Oxygen-induced Retinopathy

    (Molecular Vision, 2008) Akula, James; Mocko, Julie A.; Benador, Ilan Y.; Hansen, Ronald; Favazza, Tara L.; Vyhovsky, Tanya C.; Fulton, Anne

    Purpose: Longitudinal studies in rat models of retinopathy of prematurity (ROP) have demonstrated that abnormalities of retinal vasculature and function change hand-in-hand. In the developing retina, vascular and neural structures are under cooperative molecular control. In this study of rats with oxygen-induced retinopathy (OIR) models of ROP, mRNA expression of vascular endothelial growth factor (VEGF), semaphorin (Sema), and their neuropilin receptor (NRP) were examined during the course of retinopathy to evaluate their roles in the observed neurovascular congruency. Methods: Oxygen exposures designed to induce retinopathy were delivered to Sprague-Dawley rat pups (n=36) from postnatal day (P) 0 to P14 or from P7 to P14. Room-air-reared controls (n=18) were also studied. Sensitivities of the rod photoreceptors ((S_{rod})) and the postreceptor cells (Sm) were derived from electroretinographic (ERG) records. Arteriolar tortuosity, (T_A), was derived from digital fundus images using Retinal Image multi-Scale Analysis (RISA) image analysis software. mRNA expression of (VEGF_{164}), semaphorin IIIA (Sema3A), and neuropilin-1 (NRP-1) was evaluated by RT–PCR of retinal extracts. Tests were performed at P15–P16, P18–P19, and P25–P26. Relations among ERG, RISA, and PCR parameters were evaluated using linear regression on log transformed data. Results: Sm was low and (T_A) was high at young ages, then both resolved by P25–P26. (VEGF_{164}) and Sema3A mRNA expression were also elevated early and decreased with age. Low Sm was significantly associated with high (VEGF_{164}) and Sema3A expression. Low Srod was also significantly associated with high VEGF164. (S_{rod}) and Sm were both correlated with (T_A). NRP-1 expression was little affected by OIR. Conclusions: The postreceptor retina appears to mediate the vascular abnormalities that characterize OIR. Because of the relationships revealed by these data, early treatment that targets the neural retina may mitigate the effects of ROP.

  • Publication

    Extrafoveal Cone Packing in Eyes With a History of Retinopathy of Prematurity

    (The Association for Research in Vision and Ophthalmology, 2016) Ramamirtham, Ramkumar; Akula, James; Soni, Garima; Swanson, Matthew J.; Bush, Jennifer N.; Moskowitz, Anne; Swanson, Emily A.; Favazza, Tara L.; Tavormina, Jena L.; Mujat, Mircea; Ferguson, R. Daniel; Hansen, Ronald; Fulton, Anne

    Purpose To study the density and packing geometry of the extrafoveal cone photoreceptors in eyes with a history of retinopathy of prematurity (ROP). We used a multimodal combination of adaptive optics (AO) scanning light ophthalmoscopy (SLO) and optical coherence tomography (OCT). Methods: Cones were identified in subjects (aged 14–26 years) with a history of ROP that was either severe and treated by laser ablation of avascular peripheral retina (TROP; n = 5) or mild and spontaneously resolved, untreated (UROP; n = 5), and in term-born controls (CT; n = 8). The AO-SLO images were obtained at temporal eccentricities 4.5°, 9°, 13.5°, and 18° using both confocal and offset apertures with simultaneous, colocal OCT images. Effects of group, eccentricity, and aperture were evaluated and the modalities compared. Results: In the SLO images, cone density was lower and the packing pattern less regular in TROP, relative to CT and UROP retinae. Although SLO image quality appeared lower in TROP, root mean square (RMS) wavefront error did not differ among the groups. In TROP eyes, cone discrimination was easier in offset aperture images. There was no evidence of cone loss in the TROP OCT images. Conclusions: Low cone density in TROP confocal SLO images may have resulted from lower image quality. Since AO correction in these eyes was equivalent to that of the control group, and OCT imaging showed no significant cone loss, the optical properties of the inner retina or properties of the cones themselves are likely altered in a way that affects photoreceptor imaging.