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Retinal Pigment Epithelium Transplantation in a Non-human Primate Model for Degenerative Retinal Diseases
Published on: June 14, 2021
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Autologous Retinal Transplant for Refractory Macular Holes: Multicenter International Collaborative Study Group
Dilraj S Grewal1, Steve Charles2, Barbara Parolini3
1Department of Ophthalmology, Duke University, Durham, North Carolina.
Ophthalmology
|February 4, 2019
Summary
Autologous neurosensory retinal transplant successfully closed 87.8% of refractory large macular holes (MHs). This safe technique improved visual acuity in over half of successfully closed MHs, offering hope for challenging cases.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Regenerative Medicine
Background:
- Refractory large macular holes (MHs) pose significant challenges in achieving anatomical closure and visual recovery.
- Previous surgical interventions like vitrectomy with internal limiting membrane (ILM) peeling and gas tamponade often fail in these complex cases.
Purpose of the Study:
- To evaluate the structural and functional outcomes of autologous neurosensory retinal transplant for closing refractory large macular holes (MHs).
Main Methods:
- A multicenter, retrospective study included 41 eyes with full-thickness MHs refractory to prior surgeries.
- Patients underwent pars plana vitrectomy with autologous neurosensory retinal transplant, followed by various tamponade methods.
- Outcomes assessed included anatomical closure via OCT, ellipsoid zone (EZ) and external limiting membrane (ELM) defect changes, visual acuity (VA) recovery, and complications.
Main Results:
- Complete anatomical closure of MHs was achieved in 87.8% of eyes (36/41).
- Mean corrected visual acuity (logMAR) improved significantly (P=0.03) post-surgery.
- Significant reduction in ellipsoid zone (EZ) and external limiting membrane (ELM) defects was observed (P=0.007 and P=0.017, respectively).
- Major complications were rare, including one case each of retinal detachment and vitreous hemorrhage.
Conclusions:
- Autologous retinal transplant is a safe and effective technique for achieving anatomical closure in refractory large macular holes.
- The procedure demonstrates promising functional outcomes, with a high success rate in improving visual acuity.
- This initial experience suggests a valuable therapeutic option for previously untreatable macular hole cases.
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