SAFETY AND THERAPEUTIC EFFECTS OF ORALLY ADMINISTERED AKST4290 IN NEWLY DIAGNOSED NEOVASCULAR AGE-RELATED MACULAR DEGENERATION.

PURPOSE: To evaluate the safety and therapeutic effects of orally administered AKST4290 (formerly BI 144807 and ALK4290) in treatment-naive patients with neovascular age-related macular degeneration. METHODS: In this prospective, multicenter, open-label Phase 2a pilot clinical study, 30 patients with newly diagnosed neovascular age-related macular degeneration self-administered AKST4290 (400 mg) orally twice daily for 6 weeks. Patients were examined weekly for safety, to measure best-corrected visual acuity (BCVA), and to perform exploratory morphologic assessments. The primary endpoint was the mean change in BCVA from baseline to end of treatment, and the secondary endpoint was safety. Exploratory endpoints investigated potential changes in macular morphology. RESULTS: Mean BCVA improved by +7.0 letters (95% CI, 2.2-11.7); 24 patients (82.8%) had stable or improved BCVA, with 6 (20.7%) gaining ≥15 letters. No patients experienced severe or serious adverse events. CONCLUSION: In this 6-week study, AKST4290 treatment was associated with improved BCVA scores in patients with treatment-naive neovascular age-related macular degeneration. All adverse events were mild or moderate in severity and no safety issues were identified. Treatment of neovascular age-related macular degeneration with AKST4290 warrants further investigation in randomized, placebo-controlled trials.

Hepatic CT attenuation differs in three species of freshwater turtles and hepatic Hounsfield units increase with folliculogenesis in wild Blanding's turtles (Emydoidea blandingii).

Freshwater turtle species are suffering from anthropocentric-caused population declines, making preservation of professionally managed populations increasingly important. Turtles under professional care have an increased risk to develop hepatic lipidosis, potentially resulting in early death. Computed tomography can provide an antemortem screening for increased fatty liver composition. A goal of this prospective analytical cross-sectional study was to assess the hepatic attenuation measured as Hounsfield units (HU) in a wild population of a freshwater turtle species, and then compare hepatic HU to freshwater turtles under professional care. Ninety-five wild Blanding's turtles (BT; Emydoidea blandingii) as well as 10 Vietnamese Pond turtles (VPT; Mauremys annamensis) and six Northern Snake-Necked turtles (NSNT; Chelodina oblonga) under professional care underwent CT with quantification of hepatic HU. Hepatic HU were correlated to serum chemistry findings and the presence of follicles was recorded in BT. The mean (±SD) hepatic attenuation for 95 wild BT was 97.5 HU ±9.6. There were significant differences in hepatic attenuation among VPT, NSNT, and BT, with median HU values (range) of 5.39 HU (-6.45 to 61.50), 71.74 HU (59.44-94.49), and 95.43 HU (74.41-124.56), respectively. Aspartate aminotransferase (AST) values had a weak negative correlation to HU with a coefficient of -0.85 (P < .001). The hepatic attenuation was significantly higher for individuals undergoing folliculogenesis (P = .007). The decreased HU values were significantly negatively correlated with AST values. Findings supported the use of CT as an aid for guiding future management practices in freshwater turtles.

EPIDEMIOLOGY OF EMYDOIDEA HERPESVIRUS 1 IN FREE-RANGING BLANDING'S TURTLES (EMYDOIDEA BLANDINGII) FROM ILLINOIS.

Herpesvirus infections have been associated with high morbidity and mortality in populations of captive emydid chelonians worldwide, but novel herpesviruses have also recently been identified in apparently healthy free-ranging emydid populations. Blanding's turtle (Emydoidea blandingii), an endangered species in Illinois, has experienced range-wide declines because of habitat loss, degradation, and fragmentation. A novel herpesvirus, Emydoidea herpesvirus 1 (EBHV1), was identified in Blanding's turtles in DuPage County, IL, in 2015. Combined oral-cloacal swabs were collected from radio transmitter-fitted and trapped (n = 54) turtles multiple times over the 2016 activity season. In addition, swabs were collected at a single time point from trapped and incidentally captured (n = 84) Blanding's turtles in DuPage (n = 33) and Lake (n = 51) counties over the same field season. Each sample was tested for EBHV1 using quantitative polymerase chain reaction (qPCR). EBHV1 was detected in 15 adult females for an overall prevalence of 10.8% (n = 15/138; 95% confidence interval [CI]: 6.2-17.3%). In radio transmitter-fitted females, there was a significantly higher prevalence of EBHV1 DNA in May (23.8%, n = 10/42) than June (3.6%, n = 1/28), July (0%, n = 0/42), August (0%, n = 0/47), or September (7.7%, n = 3/39) (odds ratio: 12.19; 95% CI: 3.60-41.30). The peak in May corresponds to the onset of nesting and may be associated with increased physiologic demands. Furthermore, all positive turtles were qPCR negative in subsequent months. There were no clinical signs associated with EBHV1 detection. This investigation is the critical first step to characterizing the implications of EBHV1 for Blanding's turtle population health and identifying management changes that may improve sustainability.

MEASURING FAT CONTENT USING COMPUTED TOMOGRAPHY TO ESTABLISH A BODY CONDITION INDEX IN FREE-RANGING BLANDING'S TURTLES (EMYDOIDEA BLANDINGII) IN ILLINOIS.

Health assessment of free-ranging populations requires an integrated approach, often incorporating a method to measure mass as a representation of the animals' ability to utilize environmental resources. In chelonians, direct measurements of mass have historically served as a corollary for body condition. However, this method may not accurately represent the true fat volume (FV) and may be skewed by the presence of eggs, shell size, or muscle mass. The objective of this study was to use computed tomography (CT) to develop a model for determining body condition index (BCI) in free-ranging Blanding's turtles (Emydoidea blandingii). Mass, shell measurements, and FV were measured by CT in 65 free-ranging Blanding's turtles from Lake and DuPage counties in Illinois. Twenty-one different models were built for BCI using both FV and fat percentage (FP) as dependent variables. The best fit model for FP included the relationship between mass and carapace length with nearly 60% model support. The model for FV demonstrated a similar relationship but had only 18% support. Linear models with BCI as the dependent variable showed that juveniles had a higher FP than adults and females with more eggs had a lower FP. FP can be calculated in the field with nearly 60% accuracy compared to CT-assessed FP as a component of a physical exam and population health survey to assess the effectiveness of conservation efforts for the endangered Blanding's turtle.