A new experimental treatment for age-related neovascular macular degeneration with stem cell transplantation

Introduction: Age-related macular degeneration (AMD) is a central visual field loss while the periph­ery remains unaffected. Its inheritance pattern is autosomal dominant but it is also predetermined by environmental and nutritional factors. There is an atrophic and neovascular form of the macular degeneration. The first form is characterized with the accumulation of yellow deposits and the sec­ond form - by abnormally fragile blood vessels growing underneath the macula where they can leak and damage it. The condition worsens gradually over time. Patients complain from blurred and dis­torted vision, decrease in contrast of colours and some areas of the vision may be missing. There is no cure but some treatments can slow down the progression. A new way of treatment is being developed for the wet form - stem cell transplantation.Materials and methods: The information was gathered by using the following keywords: macular de­generation, wet form, stem cells, transplantation. Several articles and an experimental study from The New England Journal of Medicine were reviewed. The study included two patients.Results: Stem cell transplantation aims to replace the retinal pigment epithelial (RPE) cells using in­duced pluripotent stem cells (iPSC). They are generated from skin fibroblasts taken from the patient with wet AMD and are differentiated into RPE cells. The neovascular membrane is removed surgical­ly and the autologous iPSC sheet is transplanted under the retina. One year after the transplantation there is no rejection of the graft or recurrence of the neovascular membrane. The iPSC sheet length­ens in time which means that it is functioning. There is no sign of malignant proliferation.Conclusions: The visual acuity of the patient is not improved but stays as preoperatively. The patient reports for `brighter` vision probably due to the removal of the neovascular membrane. The patient is to be further observed and examined