Wu Kevin Y, Osman Rahma M, Esomchukwu Obinna, Marchand Michael, Nguyen Bich H, Tran Simon D
Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC, Canada.
Department of Medicine, School of Medicine, Queen's University, Kingston, ON, Canada.
Adv Exp Med Biol. 2025 Mar 26. doi: 10.1007/5584_2025_854.
Regenerative medicine, cell therapy, and 3D bioprinting represent promising advancements in addressing retinal and glaucomatous diseases. These conditions, including diabetic retinopathy (DR), age-related macular degeneration (AMD), inherited retinal degenerations (IRDs), and glaucomatous optic neuropathy, have complex pathophysiologies that involve neurodegeneration, oxidative stress, and vascular dysfunction. Despite significant progress in conventional therapies, including anti-VEGF injections, laser photocoagulation, and intraocular pressure (IOP)-lowering interventions, these approaches remain limited in reversing disease progression and restoring lost visual function.This chapter explores the potential of emerging regenerative therapies to fill these critical gaps. For retinal diseases, cell replacement strategies using human embryonic stem cells (hESCs), induced pluripotent stem cells (iPSCs), and mesenchymal stem cells (MSCs) have demonstrated encouraging outcomes in clinical trials, though challenges in delivery and long-term integration persist. Similarly, neuroprotective strategies and the use of retinal progenitor cells hold promise for preserving and restoring vision in degenerative retinal conditions. Advances in 3D bioprinting and retinal organoids further augment these efforts, offering innovative tools for disease modeling and therapy development.In glaucoma, regenerative approaches targeting trabecular meshwork (TM) dysfunction and retinal ganglion cell (RGC) loss are gaining traction. Stem cell-based therapies have shown potential in restoring TM functionality and providing neuroprotection, while innovative delivery systems and bioengineered platforms aim to enhance therapeutic efficacy and safety.This chapter provides an overview of the evolving landscape of regenerative therapies for retinal and glaucomatous diseases, highlighting current advancements, ongoing challenges, and future directions in the field. These approaches, while still emerging, hold the potential to transform the management of these complex ocular diseases.
再生医学、细胞疗法和3D生物打印代表了在治疗视网膜疾病和青光眼方面有前景的进展。这些病症，包括糖尿病性视网膜病变（DR）、年龄相关性黄斑变性（AMD）、遗传性视网膜变性（IRD）和青光眼性视神经病变，具有复杂的病理生理学，涉及神经退行性变、氧化应激和血管功能障碍。尽管在传统疗法方面取得了重大进展，包括抗血管内皮生长因子（VEGF）注射、激光光凝和降低眼压（IOP）的干预措施，但这些方法在逆转疾病进展和恢复丧失的视觉功能方面仍然有限。本章探讨了新兴再生疗法填补这些关键空白的潜力。对于视网膜疾病，使用人类胚胎干细胞（hESC）、诱导多能干细胞（iPSC）和间充质干细胞（MSC）的细胞替代策略在临床试验中已显示出令人鼓舞的结果，尽管在递送和长期整合方面仍存在挑战。同样，神经保护策略和视网膜祖细胞的使用有望在退行性视网膜疾病中保留和恢复视力。3D生物打印和视网膜类器官的进展进一步增强了这些努力，为疾病建模和治疗开发提供了创新工具。在青光眼中，针对小梁网（TM）功能障碍和视网膜神经节细胞（RGC）丢失的再生方法越来越受到关注。基于干细胞的疗法已显示出恢复TM功能和提供神经保护的潜力，而创新的递送系统和生物工程平台旨在提高治疗效果和安全性。本章概述了视网膜疾病和青光眼性疾病再生疗法的不断发展的格局，强调了该领域当前的进展、持续的挑战和未来的方向。这些方法虽然仍在兴起，但有可能改变这些复杂眼病的管理方式。
