Caporossi Tomaso, Scampoli Alessandra, Baldascino Antonio, Gambini Gloria, Pacini Bianca, Governatori Lorenzo, Bacherini Daniela, Carlà Matteo Mario, Crincoli Emanuele, Rizzo Clara, Kilian Raphael, Rizzo Stanislao
Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", 00168 Rome, Italy.
Ophthalmology Unit, Catholic University "Sacro Cuore", 00168 Rome, Italy.
Life (Basel). 2022 Nov 30;12(12):1998. doi: 10.3390/life12121998.
Macular neovascularization (MNV) and geographic atrophy can complicate age-related macular degeneration (AMD) and lead to severe visual acuity reduction. Despite the medical treatments available, with a defect in the retinal pigmented epithelium (RPE) there is no possibility of restoring acceptable visual acuity. We evaluated postoperative outcomes in patients affected by advanced AMD who underwent subretinal implant of the human amniotic membrane (hAM) as a source of pluripotent stem cells. This retrospective, consecutive, non-randomized interventional study included 23 eyes of 21 patients affected by AMD complicated by MNV, and five eyes of five patients affected by geographic atrophy. All eyes underwent a pars plana vitrectomy, neovascular membrane removal for the MNV group, a subretinal implant of hAM, and gas tamponade, and were followed for 12 months. The primary study outcome was visual acuity improvement. Secondary outcomes were postoperative complications, OCT-angiography parameters correlated with best-corrected visual acuity (BCVA) and MNV recurrence. The mean preoperative BCVA was 1.9 logMAR, and the mean final BCVA value was 1.2 logMAR. In the MNV group, the mean BCVA improved from 1.84 logMAR to 1.26 logMAR, and from 1.84 logMAR to 1.32 logMAR in the geographic atrophy group. No MNV recurrence was evident in 12 months of follow-up. An OCT-angiography scan was used to evaluate the retinal vascularization in the treated eye, which showed a high correlation between BCVA and deep vascular density. This study demonstrates the hAM potential and safety in promoting a partial restoration of retinal function together with an increase in visual acuity.
黄斑新生血管形成（MNV）和地图样萎缩可使年龄相关性黄斑变性（AMD）复杂化，并导致严重的视力下降。尽管有可用的药物治疗，但由于视网膜色素上皮（RPE）存在缺陷，恢复可接受的视力是不可能的。我们评估了晚期AMD患者接受人羊膜（hAM）视网膜下植入作为多能干细胞来源后的术后结果。这项回顾性、连续性、非随机干预性研究纳入了21例患有MNV并发症的AMD患者的23只眼，以及5例患有地图样萎缩的患者的5只眼。所有眼睛均接受了玻璃体切除术、MNV组的新生血管膜切除、hAM视网膜下植入和气液填充，并随访12个月。主要研究结果是视力改善。次要结果是术后并发症、与最佳矫正视力（BCVA）相关的光学相干断层扫描血管造影参数以及MNV复发。术前平均BCVA为1.9 logMAR，最终平均BCVA值为1.2 logMAR。在MNV组中，平均BCVA从1.84 logMAR提高到1.26 logMAR，在地图样萎缩组中从1.84 logMAR提高到1.32 logMAR。在12个月的随访中未发现明显的MNV复发。使用光学相干断层扫描血管造影扫描评估治疗眼的视网膜血管化，结果显示BCVA与深部血管密度之间存在高度相关性。这项研究证明了hAM在促进视网膜功能部分恢复以及提高视力方面的潜力和安全性。
