1,354,429 research outputs found
Regenerative Therapy by Suprachoroidal Cell Autograft in Dry Age-related Macular Degeneration: Preliminary In Vivo Report.
No full textThis study is aimed at examining whether a suprachoroidal graft of autologous cells can improve best corrected visual acuity (BCVA) and responses to microperimetry (MY) in eyes affected by dry Age-related Macular Degeneration (AMD) over time through the production and secretion of growth factors (GFs) on surrounding tissue. Patients were randomly assigned to each study group. All patients were diagnosed with dry AMD and with BCVA equal to or greater than 1 logarithm of the minimum angle of resolution (logMAR). A suprachoroidal autologous graft by Limoli Retinal Restoration Technique (LRRT) was carried out on group A, which included 11 eyes from 11 patients. The technique was performed by implanting adipocytes, adipose-derived stem cells obtained from the stromal vascular fraction, and platelets from platelet-rich plasma in the suprachoroidal space. Conversely, group B, including 14 eyes of 14 patients, was used as a control group. For each patient, diagnosis was verified by confocal scanning laser ophthalmoscope and spectral domain-optical coherence tomography (SD-OCT). In group A, BCVA improved by 0.581 to 0.504 at 90 days and to 0.376 logMAR at 180 days (+32.20%) postoperatively. Furthermore, MY test increased by 11.44 dB to 12.59 dB at 180 days. The different cell types grafted behind the choroid were able to ensure constant GF secretion in the choroidal flow. Consequently, the results indicate that visual acuity (VA) in the grafted group can increase more than in the control group after six months
Stem cell surgery and growth factors in retinitis pigmentosa patients: pilot study after literature review
No full textTo evaluate whether grafting of autologous mesenchymal cells, adipose-derived stem cells, and platelet-rich plasma into the supracoroideal space by surgical treatment with the Limoli retinal restoration technique (LRRT) can exert a beneficial eect in retinitis pigmentosa (RP) patients. Twenty-one eyes underwent surgery and were divided based on retinal foveal thickness (FT) 190 or > 190 m into group A-FT and group B-FT, respectively. The specific LRRT triad was grafted in a deep scleral pocket above the choroid of each eye. At 6-month follow-up, group B showed a non-significant improvement in residual close-up visus and sensitivity at microperimetry compared to group A. After an in-depth review of molecular biology studies concerning degenerative phenomena underlying the etiopathogenesis of retinitis pigmentosa (RP), it was concluded that further research is needed on tapeto-retinal degenerations, both from a clinical and molecular point of view, to obtain better functional results. In particular, it is necessary to increase the number of patients, extend observation timeframes, and treat subjects in the presence of still trophic retinal tissue to allow adequate biochemical and functional catering
Mesenchymal stem cell surgery, rescue, and regeneration in glaucomatous optic neuropathy
No full textBackground: Glaucomatous optic neuropathy (GON) is an anatomofunctional impairment of the optic nerve triggered by glaucoma. Recently, growth factors (GF) have been shown to produce retinal neuroenhancement. The suprachoroidal autograft of mesenchymal stem cells (MSC) by Limoli Retinal Restoration Technique (LRRT) has proven to achieve retinal neuroenhancement by producing GF directly into the choroidal space. This retrospectively registered clinical study investigated the visual function changes in patients with GON treated with LRRT. Methods: Twenty-five patients (35 eyes) with GON in progressive disease conditions were included in the study. Each patient underwent a comprehensive ocular examination, including analysis of Best Corrected Visual Acuity (BCVA) for far and near visus, sensitivity by Maia microperimetry, and the study of the spectral domain-optical coherence tomography (SD-OCT). The patients were divided into two groups: a control group, consisting of 21 eyes (average age 72.2 years, range 50-83) and an LRRT group, consisting of 14 eyes (average age 67.4, range 50-84). Results: After 6 months the BCVA, close-up visus, and microperimetric sensitivity significantly improved in the LRRT-treated group (p<0.05), whereas the mean increases were not statistically significant in controls (p>0.5). Conclusions: Patients with GON treated with LRRT showed a significant increase of visual performance (VP) both in BCVA and sensitivity and an improvement of residual close-up visus, in the comparison between the LRRT results and the control group. Further studies will be needed to establish the actual significance of the reported findings
Regenerative therapy by suprachoroidal cell autograft in dry age-related macular degeneration: preliminary in vivo report
No full textThis study is aimed at examining whether a suprachoroidal graft of autologous cells can improve best corrected visual acuity (BCVA) and responses to microperimetry (MY) in eyes affected by dry Age-related Macular Degeneration (AMD) over time through the production and secretion of growth factors (GFs) on surrounding tissue. Patients were randomly assigned to each study group. All patients were diagnosed with dry AMD and with BCVA equal to or greater than 1 logarithm of the minimum angle of resolution (logMAR). A suprachoroidal autologous graft by Limoli Retinal Restoration Technique (LRRT) was carried out on group A, which included 11 eyes from 11 patients. The technique was performed by implanting adipocytes, adipose-derived stem cells obtained from the stromal vascular fraction, and platelets from platelet-rich plasma in the suprachoroidal space. Conversely, group B, including 14 eyes of 14 patients, was used as a control group. For each patient, diagnosis was verified by confocal scanning laser ophthalmoscope and spectral domain-optical coherence tomography (SD-OCT). In group A, BCVA improved by 0.581 to 0.504 at 90 days and to 0.376 logMAR at 180 days (+32.20%) postoperatively. Furthermore, MY test increased by 11.44 dB to 12.59 dB at 180 days. The different cell types grafted behind the choroid were able to ensure constant GF secretion in the choroidal flow. Consequently, the results indicate that visual acuity (VA) in the grafted group can increase more than in the control group after six months
Preliminary study on electrophysiological changes after cellular autograft in age-related macular degeneration
No full textBackground: Evolving atrophic macular degeneration represents at least 80% of all macular degenerations and is currently without a standardized care. Autologous fat transplantation (AFT) efficacy was demonstrated by several studies, since these cells are able to produce growth factors. The aim of the work was to demonstrate possible therapeutic effect of the joined suprachoroidal graft of adipocytes, adipose derived stem-cells (ADSCs) in tissue adipose’s stromal vascular fractions (SVF), and platelet rich plasma (PRP).
Methods: Twelve eyes in 12 dry age macular degeneration (AMD) patients, aged 71.25 (SD ± 6.8) between 62 and 80 years, were analyzed. A complete ocular evaluation was performed using: best corrected visual acuity (BCVA), retinographic analysis, spectral-domain optical coherence tomography, microperimetry, computerized visual field, and standard electroretinogram (ERG). Each eye received a cell in graft between choroid and sclera by means of the variant second Limoli, grafting of mature fat cells and ADSCs in SVF enriched with PRP (LRRT). In order to test if the differences pre- and post-treatment were significant the Wilcoxon signed rank test has been performed.
Results: Adverse effects were not reported in the patients. After surgery with LRRT the most significant increase in the ERG values was recorded by scotopic rod-ERG (answer coming from the rods), from 41.26 to 60.83 μVolts (μV) with an average increase of 47.44% highly significant (p<0.05). Moderately significant was the one recorded by scotopic maximal ERG (answer coming from the rods and cones), from 112.22 to 129.68 μV with an average increase of 15.56% (p<0.1).
Conclusions: Cell-mediated therapy based on growth factors used appears interesting because it can improve the retinal functionality responses in the short term. The ERG could, therefore, be used to monitor the effect of cell-mediated regenerative therapies
Can cell-based therapy in patients with optic atrophy be considered a biological visual rehabilitation?
No full textPurpose : Optic atrophy (OA) is usually the end-stage of many diseases of the optic nerve. Up-to-date optical magnification devices are the only option to improve visual abilities in patients with OA. Recent studies have reported that growth factors (GF), directly or in cell-mediated mode, can be responsible for neuroenhancement effects. Among different techniques, Limoli Retinal Restoration Technique (LRRT), builds a suprachoroidal autograft of adipocytes, adipose-derived stem cells and platelets, able to produce directly into the choroidal space GF and, consequently, retinal neuroenhancement. We performed a retrospective, observational clinical study to explore changes in the visual function of patients with OA treated with LRRT.
Methods : Inclusion criteria was stabilized OA. Exclusion criteria the coexistence of other eye diseases like high myopia, retinitis pigmentosa, cataract, macular degeneration, or very disabling brain disorders. 33 eyes of 20 low vision patients (15 males and 5 females), mean age of 43.12 years (range 16-84), were recruited. The eyes were divided into two groups: A as a control (16 eyes), B treated with LRRT (17 eyes). Each patient performed a base-line and 6 months follow-up, complete eye examination including BCVA (logMAR), near visus (pt), threshold sensitivity (TS) by Maia microperimetry (dB) and fundus examination. The tenets of the Declaration of Helsinki were observed.
Results : After 6 months, the mean BCVA in group A changed from 0.720 to 0.698 logMAR (+3.10% - P> 0.5), while group B from 0.638 to 0.632 logMAR (+0.95% - P> 0.5). Mean near visus in group A changed from 25,38 to 25 pts (+1.50% - P> 0.5), while in B from 25,53 to 18,76 pts (+25.52% - P> 0.5). Mean TS in group A changed from 6.27 to 6.59 dB (+6.16% - P> 0.5) while in B from 7.37 to 9,09 dB (+23.34% - P> 0.5). In all eyes near visus was achieved with mean magnification of 3X.
Conclusions : This study shows that the LRRT may improve visual performance in visually impaired patients. Further studies are encourage to determine if biological rehabilitation is possible with cell-based therapy as retinal neuroenhancement
Mesenchymal stem cell surgery, rescue and regeneration in retinitis pigmentosa: clinical and rehabilitative prognostic aspects
No full textPurpose: To assess whether treatment with the Limoli Retinal Restoration Technique (LRRT) can be performed in patients with retinitis pigmentosa (RP), grafting the autologous cells in a deep scleral pocket above the choroid of each eye to exert their beneficial effect on the residual retinal cells. Methods: The patients were subjected to a complete ophthalmological examination, including best corrected visual acuity (BCVA), close-up visus measurements, spectral domain-optical coherence tomography (SD-OCT), microperimetry (MY), and electroretinography (ERG). Furthermore, the complete ophthalmological examination was carried out at baseline (T0) and at 6 months (T180) after surgery. The Shapiro-Wilk test was used to assess the normality of distribution of the investigated parameters. A mixed linear regression model was used to analyse the difference in all the studied parameters at T0 and T180, and to compare the mean change between the two groups. All statistical analyses were performed with STATA 14.0 (Collage Station, Texas, USA). Results: LRRT treatment was performed in 34 eyes of 25 RP patients recruited for the study. The eyes were classified in two groups on the basis of foveal thickness (FT) assessed by SD-OCT: 14 eyes in Group A (FT≤190μm) and the remaining 20 ones in Group B (FT > 190μm). Although it had not reached the statistical significance, Group B showed a better improvement in BCVA, residual close-up visus and sensitivity than Group A. Conclusions: Previous studies have described the role of LRRT in slowing down retinal degenerative diseases. Consequently, this surgical procedure could improve the clinical and rehabilitative prognostic parameters in RP patients. On the other hand, further clinical research and studies with longer follow-up will be needed to evaluate its efficacy
Mesenchymal stem cells for treatment of retinitis pigmentosa: short review
No full textThe management of retinitis pigmentosa (RP) and its progression has always been a difficult issue, but promising developments have been shown by the use of mesenchymal stem cells (MSCs). It has thus been evidenced how these cells have significant paracrine and immunomodulatory properties: they secrete trophic factors that stimulate RPE or that are similar to those produced by RPE. In studies using animal models, MSCs have been found to be effective in stopping the progression of retinal degeneration and for rescuing photoreceptors in the dormant phase. Furthermore these cells are hypoimmunogenic and have been shown to suppress chronic inflammation, prevent apoptosis and stimulate progenitor cells in the retina promoting self-repair mechanisms.
Previous studies have already evidenced how grafting autologous mesenchymal cells, in a scleral pocket above the choroid, with the limoli retinal restoration technique (LRRT) could exert a beneficial effect on the residual retinal cells in patients with retinitis pigmentosa (RP).
This surgical procedure can improve the clinical and rehabilitative prognostic parameters in RP patients even though further researches and studies will be needed to evaluate its efficacy
Potential guidelines for cataract surgery and rehabilitation in visually impaired patients: literature analysis
No full textCataracts can reduce the quality of vision in visually impaired patients who already have a visual impairment. The most common causes of low vision include age-related macular degeneration (AMD), high myopia (HM), diabetic retinopathy (DR), glaucoma (GL), and inherited degenerative ocular diseases. The surgery aims to improve their independence, quality of life, and ability to engage in daily, social, and work activities. Phacoemulsification and intraocular lens (IOL) implantation, combined with visual rehabilitation, can improve visual acuity of visually impaired patients. Therefore, comprehensive guidelines for cataract surgery in patients with low vision would be beneficial to ensure optimal surgical outcomes by improving surgical planning, execution, and postoperative care, along with a well-coordinated rehabilitation process. In cases of reduced metabolism, such as low vision, oxidative stress can be aggravated by light exposure and surgical interventions. Thus, maintaining redox balance is crucial for stabilizing retinal conditions. Patients with visual impairments rely on retinal regions with the greatest residual function, and cataract surgery aims to enhance focus on these areas, improving reading quality and reducing scotoma perception. Thorough informed consent is crucial, ensuring that patients are fully aware of the potential risks, benefits, and limitations of surgery. Close postoperative follow-up in the first 6 months is crucial to detect and manage any complications promptly, such as reactivation of maculopathy. The aim of this work is to establish potential guidelines for optimal rehabilitation outcomes through careful literature analysis
Restorative action of stem cells in neuroretinal degenerations as a possible application by ocular mesenchymal autograft
No full textThis research wanted to explore the recent and future therapeutic possibilities in patients affected by neuroretinal degeneration
through the use of stem cells. There are numerous degenerative neuroretinal diseases, each with its own etiology and
genetics, including glaucoma, age-related macular degeneration, degenerative myopia, diabetic retinopathy, inherited retinal
dystrophies, etc. Molecular dysfunction may initially affect neural cells, ganglion cells, photoreceptors (cones or rods), and
support cells, such as Müller cells or retinal pigment epithelium cells. As the disease progresses, dysfunction and subsequent
loss of these cells lead to severe sensory impairment: the end result is the permanent and irreversible loss of vision or part of
it. In the last two decades, new therapeutic avenues aimed at treating degenerative eye diseases have been hypothesized. These
approaches include restoration of defective genes, when the disease is caused by a genetic defect, and stem cell transplantation
to replace dead cells or repair defective ones, regardless of the cause. Moreover, for gene therapy to be effective, it
should be applied before the retina is compromised by the degenerative disease. For this reason, the interest of the scientific
community has also turned to restorative strategies based on the use of stem cells, either systemically injected or locally
implanted. There are numerous advantages to using cell therapy in ophthalmology. The surgical approach is theoretically
simple and potentially within the reach of ophthalmologists. The effect of cell transplantation can be easily monitored with
currently available imaging methods. According to the case, the contralateral eye could be used as a control. Long-term
immunosuppressive treatment is not required either in the case of heterologous implants because of the immune privilege
of the eye or of autologous cells. In summary, the study investigated the various issues described above in light of the
new regenerative therapies with stem cells
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