Limoli Paolo Giuseppe, Vingolo Enzo Maria, Limoli Celeste, Scalinci Sergio Zaccaria, Nebbioso Marcella
Low Vision Research Centre of Milan.
Department of Ophthalmology, A. Fiorini Hospital, Sapienza University of Rome.
J Vis Exp. 2018 Feb 12(132):56469. doi: 10.3791/56469.
This study is aimed at examining whether a suprachoroidal graft of autologous cells can improve best corrected visual acuity (BCVA) and responses to microperimetry (MY) in eyes affected by dry Age-related Macular Degeneration (AMD) over time through the production and secretion of growth factors (GFs) on surrounding tissue. Patients were randomly assigned to each study group. All patients were diagnosed with dry AMD and with BCVA equal to or greater than 1 logarithm of the minimum angle of resolution (logMAR). A suprachoroidal autologous graft by Limoli Retinal Restoration Technique (LRRT) was carried out on group A, which included 11 eyes from 11 patients. The technique was performed by implanting adipocytes, adipose-derived stem cells obtained from the stromal vascular fraction, and platelets from platelet-rich plasma in the suprachoroidal space. Conversely, group B, including 14 eyes of 14 patients, was used as a control group. For each patient, diagnosis was verified by confocal scanning laser ophthalmoscope and spectral domain-optical coherence tomography (SD-OCT). In group A, BCVA improved by 0.581 to 0.504 at 90 days and to 0.376 logMAR at 180 days (+32.20%) postoperatively. Furthermore, MY test increased by 11.44 dB to 12.59 dB at 180 days. The different cell types grafted behind the choroid were able to ensure constant GF secretion in the choroidal flow. Consequently, the results indicate that visual acuity (VA) in the grafted group can increase more than in the control group after six months.
本研究旨在探讨自体细胞脉络膜上移植能否通过在周围组织中产生和分泌生长因子(GFs),随时间改善干性年龄相关性黄斑变性(AMD)患者眼睛的最佳矫正视力(BCVA)以及微视野检查(MY)的反应。患者被随机分配到各研究组。所有患者均被诊断为干性AMD,且BCVA等于或大于最小分辨角对数(logMAR)的1个对数。A组对11例患者的11只眼睛进行了Limoli视网膜修复技术(LRRT)的脉络膜上自体移植。该技术通过将脂肪细胞、从基质血管成分中获得的脂肪来源干细胞以及富含血小板血浆中的血小板植入脉络膜上腔来进行。相反,B组包括14例患者的14只眼睛,用作对照组。对每位患者,通过共焦扫描激光检眼镜和光谱域光学相干断层扫描(SD-OCT)进行诊断核实。在A组中,术后90天时BCVA从0.581提高到0.504,180天时提高到0.376 logMAR(提高了32.20%)。此外,180天时MY测试提高了11.44 dB至12.59 dB。脉络膜后移植的不同细胞类型能够确保在脉络膜血流中持续分泌GFs。因此,结果表明,六个月后移植组的视力(VA)提高幅度大于对照组。