Evaluation of Transplanted Autologous Induced Pluripotent Stem Cell-Derived Retinal Pigment Epithelium in Exudative Age-Related Macular Degeneration

Autor: Masayo Takahashi, Yasuo Kurimoto, Kiyoko Gocho, Masashi Fujihara, Sunao Sugita, Michiko Mandai, Yasuhiko Hirami, Midori Yamamoto, Seiji Takagi
Rok vydání: 2018
Předmět:
Pluripotent Stem Cells
medicine.medical_specialty
genetic structures
Fundus Oculi
Visual Acuity
Ophthalmologic Surgical Procedures
Retinal Pigment Epithelium
Transplantation
Autologous
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Ophthalmology
medicine
Autologous transplantation
Humans
Fluorescein Angiography
030304 developmental biology
Aged
Retrospective Studies
0303 health sciences
Retina
Retinal pigment epithelium
medicine.diagnostic_test
business.industry
Retinal
Macular degeneration
medicine.disease
Fluorescein angiography
eye diseases
Transplantation
medicine.anatomical_structure
Choroidal neovascularization
chemistry
030221 ophthalmology & optometry
Wet Macular Degeneration
Female
sense organs
medicine.symptom
business
Tomography
Optical Coherence
Follow-Up Studies
Zdroj: Ophthalmology. Retina. 3(10)
ISSN: 2468-6530
Popis: Purpose To report the results after 4 years of follow-up in a previously presented first case of induced pluripotent stem cell (iPSC)-derived retinal pigment epithelium (RPE) sheet autologous transplantation using multimodal imaging. Design Follow-up of a single case. Participant A patient with exudative age-related macular degeneration and polypoidal choroidal vasculopathy. Methods Transplantation of an autologous iPSC-derived RPE cell sheet after removal of choroidal neovascularization (CNV) in September 2014. Main Outcome Measures The function of the graft was assessed 4 years after surgery by color fundus photography, spectral-domain (SD) OCT, fluorescein angiography, indocyanine green angiography, and an adaptive optics (AO) retinal camera. Results At the 4-year follow-up, the transplanted autologous iPSC-derived RPE sheet had survived beneath the retina with slight expansion of the pigmented area and no adverse events. The outer nuclear layer above and adjacent to the graft showed acceptable thickness and an organized structure. Fluorescein angiography and SD OCT suggested the presence of vessel-like structures confined to the grafted area associated with the remaining trunk vessel of preoperative polypoidal choroidal vasculopathy but with no exudative changes. Visual acuity has been stable with no additional injections of anti–vascular endothelial growth factor agent. The choroidal volume at the graft site is relatively preserved when compared with the volume outside this site without RPE after removal of the CNV. Indocyanine green angiography revealed a preserved choriocapillaris around the iPSC-derived RPE sheet. Dark cell-like structures with a predominantly hexagonal arrangement were observed by AO imaging in an area located near the margin of the graft sheet. The average intercell distance was found to be stable over time. Conclusions Thus far, the grafted iPSC-derived RPE sheet has survived for 4 years and seems to support photoreceptors and choroidal vessels. The morphologic characteristics of the RPE are observed at the transplant site.
Databáze: OpenAIRE
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