Hillenmayer Anna, Wertheimer Christian M, Gerhard Maximilian-Joachim, Priglinger Siegfried G, Ohlmann Andreas, Wolf Armin
Department of Ophthalmology, Ludwig Maximilians University Munich, Mathildenstr. 8, 80336, Munich, Germany.
Department of Ophthalmology, University of Ulm, Prittwitzstr. 43, 89075, Ulm, Germany.
Ophthalmol Ther. 2023 Jun;12(3):1635-1648. doi: 10.1007/s40123-023-00695-z. Epub 2023 Mar 11.
Amniotic membrane (AM) is a popular treatment for external ocular diseases. First intraocular implantations in other diseases reported promising results. Here, we review three cases of intravitreal epiretinal human AM (iehAM) transplantation as an adjunct treatment for complicated retinal detachment and analyze clinical safety. Possible cellular rejection reactions against the explanted iehAM were evaluated and its influence was assessed on three retinal cell lines in vitro.
Three patients with complicated retinal detachment and implanted iehAM during pars plana vitrectomy are retrospectively presented. After removal of the iehAM at subsequent surgery, tissue-specific cellular responses were studied by light microscopy and immunohistochemical staining. We investigated the influence of AM in vitro on retinal pigment epithelial cells (ARPE-19), Müller cells (Mio-M1), and differentiated retinal neuroblasts (661W) . An anti-histone DNA ELISA for cell apoptosis, a BrdU ELISA for cell proliferation, a WST-1 assay for cell viability, and a live/dead assay for cell death were performed.
Despite the severity of the retinal detachment, stable clinical outcomes were obtained in all three cases. Immunostaining of the explanted iehAM showed no evidence of cellular immunological rejection. In vitro, there was no statistical significant change in cell death or cell viability nor were proliferative effects detected on ARPE-19, Müller cells, and retinal neuroblasts exposed to AM.
iehAM was a viable adjuvant with many potential benefits for treatment of complicated retinal detachment. Our investigations could not detect any signs of rejection reactions or toxicity. Further studies are needed to evaluate this potential in more detail.
羊膜（AM）是治疗外眼疾病的常用方法。首次在其他疾病中的眼内植入报告了有前景的结果。在此，我们回顾三例玻璃体内人视网膜前羊膜（iehAM）移植作为复杂性视网膜脱离辅助治疗的病例，并分析临床安全性。评估了针对植入的iehAM可能的细胞排斥反应，并在体外评估了其对三种视网膜细胞系的影响。
回顾性呈现三例在玻璃体切割术中植入iehAM的复杂性视网膜脱离患者。在后续手术中取出iehAM后，通过光学显微镜和免疫组织化学染色研究组织特异性细胞反应。我们在体外研究了AM对视网膜色素上皮细胞（ARPE - 19）、 Müller细胞（Mio - M1）和分化的视网膜成神经细胞（661W）的影响。进行了用于细胞凋亡的抗组蛋白DNA ELISA、用于细胞增殖的BrdU ELISA、用于细胞活力的WST - 1测定以及用于细胞死亡的活/死测定。
尽管视网膜脱离严重，但所有三例均获得了稳定的临床结果。植入的iehAM的免疫染色未显示细胞免疫排斥的证据。在体外，暴露于AM的ARPE - 19、Müller细胞和视网膜成神经细胞的细胞死亡或细胞活力没有统计学上的显著变化，也未检测到增殖作用。
iehAM是治疗复杂性视网膜脱离的一种可行辅助方法，具有许多潜在益处。我们的研究未检测到任何排斥反应或毒性迹象。需要进一步研究以更详细地评估这种潜力。
