Retinal function after intravitreal injection of autologous bone marrow-derived mesenchymal stromal cells in advanced glaucoma

Abstract

Purpose

To report electroretinographic (ERG) findings in advanced glaucoma treated with a single intravitreal injection of bone marrow-derived mesenchymal stem cells (MSCs).

Methods

Intravitreal injection of autologous MSCs (1 × 106 cells) was performed in 2 eyes from 2 patients with open-angle glaucoma in advanced stage of optic neuropathy (ClinicalTrials.gov, NCT02330978, 01.05.2015): cup/disk ratio worse than 0.9, visual field mean deviation index lower than − 15 dB, visual acuity of light perception, but controlled intraocular pressure. ERG tests were recorded at baseline and week 1, 4 and 48 after injection, using DTL electrodes following the ISCEV standard: After dark adaptation, ERG was elicited using white flashes of 0.01 cd.s/m2 and 3.0 cd.s/m2, followed by 10-min light adaptation (30 cd/m2) and stimuli of 3.0 cd.s/m2 and 30 Hz flicker.

Results

Patients did not show improvement on visual acuity or visual field after treatment. At baseline, ERG responses showed typical findings for advanced glaucoma, with a- and b-wave amplitude and latency within normative range, but reduced photopic negative responses. No noteworthy changes were observed on ERG responses for both cases up to 1 week after treatment, but at day 15, one patient showed retinal detachment with proliferative vitreoretinopathy and was removed from the trial. The other patient kept ERG responses stable throughout study period.

Conclusion

Although no ERG response changes were observed after MSCs injection in one case, the complication observed on the second one, along with the lack of visual function improvement, warrants further studies involving modified MSCs to treat ocular disorders, including glaucoma.

Trial registration: ClinicalTrials.gov, NCT02330978- missed in pdf

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Availability of data and material

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Acknowledgements

We would kindly like to acknowledge Dr. Diego Villa Clé for performing the iliac crest aspiration to collect the bone marrow samples, as well as Prof. Rodrigo Jorge and Prof. Maria de Lourdes Veronese Rodrigues for discussing specific points of the methodology. We also acknowledge the CNPq - Brazil for the research Grant (Process # 401181/2013-8).

Funding

This study received a research Grant from CNPq - Brazil (Process # 401181/2013–8).

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Correspondence to Andre Messias.

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Informed consent was obtained from all individual participants included in the study.

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All authors have had full access to the entire review and agree with the decision to submit for publication.

Conflict of interest

Authors do not have any commercial or proprietary conflicting, competing interests in the materials or products described (directly or indirectly related to) in the article. The results presented in this manuscript were not presented at any previous scientific meeting.

Ethics approval

All procedures performed in this study were approved by the Ribeirão Preto Clinical Hospital Ethical Committee (process number 14151/2010) and were in accordance with Helsinki Declaration (1964) and its later amendments.

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Vilela, C.A.P., Messias, A., Calado, R.T. et al. Retinal function after intravitreal injection of autologous bone marrow-derived mesenchymal stromal cells in advanced glaucoma. Doc Ophthalmol (2021). https://doi.org/10.1007/s10633-021-09817-z

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Keywords

  • Glaucoma
  • Mesenchymal stem cells
  • Electroretinogram
  • ERG