Although no objective improvementin vision was reported, these clinical studies demonstrated the safety ofthe procedure. Using an implantation instrument and procedure originally developedby Aramant and Seiler 6 for use in rats withretinal degeneration, clinical studies have been performed in patients withRP 1, 7 to transplant intact sheetsof fetal retina with or without the RPE. 3 - 5 If the diseased photoreceptorsand/or RPE can be replaced and the new cells make appropriate connectionsto the functional part of the host retina, eyesight may be improved. 2 In these diseases, blindnessis due to specific degeneration of the photoreceptors and/or RPE cells eventhough the inner retina that connects to the brain may still remain functional. 1 Retinitispigmentosa is a group of inherited diseases with mutations in photoreceptoror RPE genes. Previously, it has been reported that intact sheets of fetal retinatogether with its retinal pigment epithelium (RPE) can be safely transplantedto patients with retinitis pigmentosa (RP). Independently, scanning laser ophthalmoscopetesting at a different institution at 9 months showed a visual acuity of 20/270at a 40° field of view.Ĭonclusion This study indicates that fetal retina transplanted with its retinalpigment epithelium can survive 1 year without apparent clinical evidence ofrejection and show continued improvement in Early Treatment Diabetic RetinopathyStudy visual acuity. Main Outcome Measures A change in visual acuity from 20/800 to 20/400 (7 months), 20/250 (9months), and 20/160 (1 year) was observed by Early Treatment Diabetic RetinopathyStudy visual acuity testing. The transplant sheet lost its pigmentation by 6 months. Results No clinical evidence of rejection was observed.
Objective To report the subjective and objective improvement in vision in a patientwith autosomal dominant retinitis pigmentosa after transplantation of a sheetof fetal neural retina together with its retinal pigment epithelium.ĭesign A sheet of fetal neural retina with its retinal pigment epithelium wastransplanted into the subretinal space under the fovea unilaterally in a patientwith retinitis pigmentosa with visual acuity of 20/800 in the treated eye.Early Treatment Diabetic Retinopathy Study visual acuity testing, scanninglaser ophthalmoscope, tissue typing of the donor and recipient, fluoresceinangiography, multifocal electroretinogram, multifocal visually evoked potential,and clinical examination were used.
Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Potential acuity meter 20/369 OD (40° fieldof view) potential acuity meter 20/270 OS (40° field of view). The patient could not consistently see the E in this location. The patient fixated on a large, horizontal black E at the nasal edge of the transplant but outside of thearea of the transplant. The bottom row shows fixation of a large, horizontal black E in the eye that was not operated on (left) and in the eye that wasoperated on (right). The eye that was operated on contained 53 seeing and 37 nonseeing areas.In contrast, the eye that was not operated on contained 33 seeing and 37 nonseeingareas. The transplant area is outlined by black-on-whitedots. The microperimetry data indicate that fixationis not stable and sometimes involves retina over the transplant area as wellas retina adjacent to the transplant. Seeing areas are indicated asfilled white squares and nonseeing areas as open white squares fixation pointsare indicated by black crosses. Scanning laser ophthalmoscope:The top row shows microperimetry of the eye that was not operated on (left)and of the eye that was operated on (right).
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