Hopkinson Andrew, Figueiredo Francisco C
Academic Ophthalmology, Division of Clinical Neuroscience, Queen's Medical Centre (QMC), University of Nottingham, Queen's Medical Centre Campus, Nottingham, NG7 2UH, UK.
NuVision Biotherapies, MediCity Nottingham, Nottingham, NG90 6BH, UK.
Ophthalmol Ther. 2025 May 14. doi: 10.1007/s40123-025-01143-w.
This narrative review explores the pathophysiology of ocular surface inflammation and highlights the therapeutic potential of patch amniotic membrane transplantation (patch-AMT) in ocular surface repair. Disruptions in ocular surface homeostasis caused by trauma, disease, or immune dysregulation trigger an inflammatory cascade that, if unresolved, can impair epithelial healing, lead to fibrosis, corneal haze, and vision loss. Patch-AMT provides a biological intervention with epitheliotropic, anti-inflammatory, anti-fibrotic, anti-angiogenic, and neuroprotective effects that support wound healing, regulate inflammation, and reduce pain. The review examines patch-AMT's role in acute conditions (chemical burns, Stevens-Johnson Syndrome) and chronic disease (persistent epithelial defects, dry eye disease), focusing on its ability to entrap immune cells, regulate cytokine signaling, and prevent fibrotic remodeling while releasing trophic proteins. Additionally, this review explores how preservation methods, application orientation, and intervention timing influences patch-AMT's efficacy. Recent advancements in non-surgical application methods have expanded accessibility, enabling earlier intervention and outpatient use. However, variability in clinical protocols emphasize the need for standardized guidelines. The review concludes by highlighting the need for further research to refine treatment timing, optimize repeat application strategies, and evaluate cost-effectiveness. While patch-AMT remains underutilized, growing evidence underscores its potential to improve clinical outcomes, particularly when applied early in disease progression.
这篇叙述性综述探讨了眼表炎症的病理生理学，并强调了羊膜贴片移植（patch-AMT）在眼表修复中的治疗潜力。由创伤、疾病或免疫失调引起的眼表稳态破坏会引发炎症级联反应，若不解决，可能会损害上皮愈合，导致纤维化、角膜混浊和视力丧失。羊膜贴片移植提供了一种生物干预手段，具有促上皮生长、抗炎、抗纤维化、抗血管生成和神经保护作用，可支持伤口愈合、调节炎症并减轻疼痛。该综述研究了羊膜贴片移植在急性病症（化学烧伤、史蒂文斯-约翰逊综合征）和慢性疾病（持续性上皮缺损、干眼病）中的作用，重点关注其捕获免疫细胞、调节细胞因子信号传导以及在释放营养蛋白的同时防止纤维化重塑的能力。此外，本综述探讨了保存方法、应用方向和干预时机如何影响羊膜贴片移植的疗效。非手术应用方法的最新进展扩大了其可及性，实现了更早的干预和门诊使用。然而，临床方案的差异强调了标准化指南的必要性。综述最后强调需要进一步研究以优化治疗时机、完善重复应用策略并评估成本效益。虽然羊膜贴片移植的应用仍不充分，但越来越多的证据强调了其改善临床结局的潜力，尤其是在疾病进展早期应用时。
