Cited by 219Retinal Diseases and TreatmentsRetinal Development and DisordersRetinal and Macular Surgery

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Long-Term Outcome of RPE Allografts in Non-Immunosuppressed Patients with AMD

Algvere, P. V., Gouras, P., Dafgård Kopp, E.·1999·European Journal of Ophthalmology

DOI 10.1177/112067219900900310

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Abstract

Purpose: To determine the long-term outcome of human retinal pigment epithelium (RPE) transplants in patients with advanced age-related macular degeneration (AMD). Methods: Using pars plana microsurgical techniques, RPE allografts were transplanted subretinally to four groups of AMD patients: five patients received organized patch transplants after removal of choroidal neovascular membranes, four got small patch transplants in dry AMD; suspensions of RPE cells were transplanted in five cases with dry AMD, and two patients with RPE tears. None received immunosuppression. Transplants were followed for 24–38 months by biomicroscopy, fundus photography, SLO microperimetry, and fluorescein angiography. Rejection was defined as loss of visual function over the transplant, development of an exudative response (subretinal fluid with or without neovascularization), fluorescein leakage, and disruption, depigmentation, or encapsulation of the transplant. Results: Four of 16 transplants (25%) presented no clinical signs of rejection. Three of the four small patch transplants remained pigmented and essentially unchanged after 30–32 months. Clinical signs of graft rejection appeared within three months in all cases of neovascular AMD (disrupted blood-retinal barrier, BRB), but after 6 - 20 months in five of nine eyes with non-exudative AMD (intact BRB). Conclusions: Subretinal human RPE allografts present a high rejection rate (75%) without immunosuppression. However, small extrafoveal transplants remained unchanged in shape, size and color for more than two years in non-exudative AMD. A disrupted BRB is likely to enhance graft rejection, which occurs earlier in exudative than in non-exudative AMD.

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Authors: Algvere, P. V., Gouras, P., & Dafgård Kopp, E.
Affiliations: Linköping University (SE)
Columbia University (US)
Department of Ophthalmology, Karolinska Institute, St. Erik's Eye Hospital, Stockholm - Sweden
ORCID: Gouras, P.
Venue: European Journal of Ophthalmology
Publisher: SAGE Publications
Published: 1999-07
Volume: 9
Issue: 3
Pages: 217-230
ISSN: 1120-6721 (ISSN-L)
1724-6016
DOI: 10.1177/112067219900900310
OpenAlex: W1480779622
Cited by: 219
References: 31
Citations by year: 2026: 2 · 2025: 4 · 2024: 4 · 2023: 8 · 2022: 3 · 2021: 8 · 2020: 9 · 2019: 9 · 2018: 9 · 2017: 6 · 2016: 6 · 2015: 13 · 2014: 4 · 2013: 4 · 2012: 11
FWCI: 8.64
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: European Journal of Ophthalmology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
Health Sciences › Medicine › Ophthalmology › Retinal Development and Disorders
Health Sciences › Medicine › Ophthalmology › Retinal and Macular Surgery
Keywords: age-related macular degeneration, graft rejection, non-immunocompromised patient, subretinal transplantation, choroidal neovascularization, dry age-related macular degeneration, long-term outcomes
MeSH terms: Age Factors, Aged, Female, Fluorescein Angiography, Graft Rejection, Humans, Immunosuppression Therapy, Macular Degeneration, Male, Middle Aged, Pigment Epithelium of Eye, Pregnancy, Ophthalmologic Surgical Procedures, Time Factors, Transplantation, Homologous, Vitrectomy, Treatment Outcome

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Long-Term Outcome of RPE Allografts in Non-Immunosuppressed Patients with AMD

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