Transplantation of fetal retinal pigment epithelium in age-related macular degeneration with subfoveal neovascularization
Abstract
Background Age-related macular degeneration (ARMD) is caused by abnormal retinal pigment epithelium (RPE) and may be complicated by choroidal neovascularization. The object of treatment would be to replace the diseased RPE with normal human RPE.Method Five patients with ARMD (preoperative visual acuity 0.08-0.2) underwent removal of subretinal fibrovascular membranes using pars plana vitrectomy techniques. Human fetal RPE (15-17 weeks gestational age) was cultured and transplanted as a monolayer patch into the subretinal space. Transplants were followed by funduscopy and fluorescein angiography. Macular function was assessed using scanning laser ophthalmoscopic (SLO) microperimetry.Results Three RPE transplants were placed in the fovea; two were placed parafoveally. All transplants have survived for 3 months. They have grown and increased in size covering part of the epithelial defect caused by removal of the fibrovascular membrane. SLO microperimetry indicated that visual function was present in four of the transplants at 1 month but in only two at 3 months after surgery. Function over the transplants, especially those in the fovea, was compromised by cystoidlike macular edema.Conclusions Human fetal RPE transplants survive well in the macula for as long as 3 months. They are capable of growing to cover epithelial defects caused by removal of subretinal neovascular membranes. The causes for development of macular edema in transplants directly in the fovea warrant further evaluation.
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Clinical trials using allogenic RPE cells for the treatment of AMD two decades ago were all met with graft rejection.
“clinical trials conducted using allogenic RPE cells for the treatment of AMD, 2 decades ago, were all met with graft rejection (38–42).”
From Subretinal therapy: technological solutions to surgical and immunological challenges (2022) · cites this paper as [38]
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- Authors
- Algvere, P. V., Berglin, L., Gouras, P., & Sheng, Y.
- Affiliations
- Karolinska Institutet (SE)
- Columbia University (US)
- ORCID
- Gouras, Peter
- Venue
- Graefe's Archive for Clinical and Experimental Ophthalmology
- Published
- 1994-12
- Volume
- 232
- Issue
- 12
- Pages
- 707-716
- ISSN
- 0721-832X (ISSN-L)
- 1435-702X
- OpenAlex
- W1993096645
- Cited by
- 346
- References
- 16
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 8 · 2023: 8 · 2022: 9 · 2021: 5 · 2020: 7 · 2019: 6 · 2018: 4 · 2017: 8 · 2016: 7 · 2015: 11 · 2014: 8 · 2013: 7 · 2012: 15
- FWCI
- 13.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Graefe s Archive for Clinical and Experimental Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
- Keywords
- age-related macular degeneration, subfoveal neovascularization, choroidal neovascularization, retinal pigment epithelium transplantation, pars plana vitrectomy, cystoid macular edema, fovea, visual function
- MeSH terms
- Aged, Cell Membrane, Cell Survival, Cells, Cultured, Choroid, Female, Fluorescein Angiography, Fovea Centralis, Fundus Oculi, Humans, Macular Degeneration, Middle Aged, Neovascularization, Pathologic, Pigment Epithelium of Eye, Postoperative Complications, Visual Acuity, Vitrectomy, Fetal Tissue Transplantation, Visual Field Tests
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