TRANSPLANTATION OF FETAL RETINAL-PIGMENT EPITHELIUM IN AGE-RELATED MACULAR DEGENERATION WITH SUBFOVEAL NEOVASCULARIZATION
TRANSPLANTATION OF FETAL RETINAL-PIGMENT EPITHELIUM IN AGE-RELATED MACULAR DEGENERATION WITH SUBFOVEAL NEOVASCULARIZATION
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DOI：
10.1007/bf00184273
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发表时间：
1994-12-01
影响因子：
2.7
通讯作者：
SHENG, YH
中科院分区：
文献类型：
--
作者：
ALGVERE, PV;BERGLIN, L;SHENG, YH
背景：年龄相关性黄斑变性（ARMD）是由视网膜色素上皮（RPE）异常引起的，可能并发脉络膜新生血管。治疗的目的是将病变的RPE替换为正常的人RPE。方法：对5例ARMD患者（术前视力0.08 ~ 0.2）采用玻璃体切割技术切除视网膜下纤维血管膜。培养人胎RPE（15-17周胎龄），并将其作为单层贴片移植到视网膜下间隙。移植后行眼底镜检和荧光素血管造影。采用扫描激光检眼镜（SLO）显微视力法评估黄斑功能。结果：3例RPE移植物放置于中央凹；其中两个放置在中间。所有移植物都存活了3个月。它们生长并增大，覆盖了因纤维血管膜切除而引起的部分上皮缺损。SLO显微镜观察显示4例移植术后1个月视力恢复，2例术后3个月视力恢复。移植物的功能，特别是中央凹的功能，因囊样黄斑水肿而受损。结论：人胎RPE移植在黄斑内存活良好，可达3个月。它们能够生长以覆盖因移除视网膜下新生血管膜而引起的上皮缺陷。直接在中央窝移植的黄斑水肿发生的原因需要进一步的评估。
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.