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The Macula pp 51-56 | Cite as

Iris pigment epithelium transplantation — experimental and clinical results

  • Gabriele Thumann
  • S. Aisenbrey
  • K. U. Bartz-Schmidt

Abstract

It has been hypothesized that transplantation of iris pigment epithelial (IPE) cells to the subretinal space may be useful in the treatment of exudative age-related macular degeneration following surgical removal of the neovascular complex. In practice, the success of IPE transplantation depends on (a) the transplantation of a sufficient number of IPE cells, (b) the ability of the transplanted IPE cells to form a monolayer that will cover the exposed photoreceptor outer segments, and (c) the acquisition of RPE cell characteristics and functions by the transplanted IPE cells.

We have transplanted autologous IPE cells as a single cell suspension to the subretinal space in 20 patients; during the three years of follow-up the cells survived and did not adversely affect photoreceptors function. Stabilization of visual acuity was achieved in the majority of patients after IPE transplantation, and by fluorescein angiography none of the twenty patients showed any sign of recurrent vascular disease. The transplanted cells appeared to have remained at the site of transplantation, however it was not possible to ascertain whether they had spread and formed a monolayer. Since the formation of a monolayer of cells is critical to the successful visual outcome of IPE transplantation, we have begun a series of experiments to optimize the culture of IPE and RPE cells and explore the feasibility of transplanting preformed monolayers of autologous IPE cells cultured on biodegradable substrates.

Keywords

Retinal Pigment Epithelial Retinal Pigment Epithelial Cell Early Treatment Diabetic Retinopathy Study Subretinal Space Choroidal Neovascular Membrane 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Algvere PV, Berglin L, Gouras P, Sheng Y (1995) Transplantation of fetal retinal pigment epithelium in age-related macular degeneration with subfoveal neovascularization. Graefe’s Arch Clin Exp Ophthalmol 232: 707–16CrossRefGoogle Scholar
  2. 2.
    Algvere PV, Berglin L, Gouras P, Sheng Y, Dafgard Kopp E (1997) Transplantation of RPE in age-related macular degeneration: observations in disciform lesions and dry RPE atrophy. Graefe’s Arch Clin Exp Ophthalmol 235: 149–58PubMedCrossRefGoogle Scholar
  3. 3.
    Algvere PV, Gouras P, Dafgard Kopp E (1999) Long-term outcome of RPE allografts in nonimmunosuppressed patients with AMD. Eur J Ophthalmol 9: 217–30PubMedGoogle Scholar
  4. 4.
    Benson MT, Callear A, Tsaloumas M, China J, Beatty S (1998) Surgical excision of subfoveal neovascular membranes. Eye 12: 768–74PubMedCrossRefGoogle Scholar
  5. 5.
    Berglin L, Algvere P, Olivestedt G, Crafoord S, Stenkula S, Hansson LJ, Tomic Z, Kvanta A, Seregard S (2001) The Swedish national survey of surgical excision for submacular choroidal neovascularization ( CNV ). Acta Ophthalmol Scand 79: 580–4PubMedCrossRefGoogle Scholar
  6. 6.
    Binder S, Stolba U, Krebs I, Kellner L, Jahn C, Feichtinger H, Povelka M, Frohner U, Kruger A, Hilgers RD, Krugluger W (2002) Transplantation of autologues retinal pigment epithelium in eyes with foveal neovascularization resulting from age-related macular degeneration: A pilot study. Am J Ophthalmol 133: 215–24PubMedCrossRefGoogle Scholar
  7. 7.
    Crafoord S, Geng L, Seregard S, Algvere PV (2001) Experimental transplantation of autologous iris pigment epithelial cells to the subretinal space. Acta Ophthalmol Scand 79: 509–14PubMedCrossRefGoogle Scholar
  8. 8.
    Eckardt C (1996) Surgical removal of submacular neovascularization membranes. Ophthalmologe 93: 688–93PubMedCrossRefGoogle Scholar
  9. 9.
    Hu DN, Ritch R, McCormick SA, Pelton-Henrion K (1992) Isolation and cultivation of human iris pigment epithelium. Invest Ophthalmol Vis Sci 33: 2443–53PubMedGoogle Scholar
  10. 10.
    Hu DN, McCormick SA, Ritch R (1997) Isolation and culture of iris pigment epithelium from iridectomy specimens of eyes with and without exfoliation syndrome. Arch Ophthalmol 1 15: 89–94CrossRefGoogle Scholar
  11. 11.
    Merrill PT, LoRusso FJ, Lomeo MD, Saxe SJ, Khan MM, Lambert HM (1999) Surgical removal of subfoveal choroidal neovascularization in age-related macular degeneration. Ophthalmology 106: 782–9PubMedCrossRefGoogle Scholar
  12. 12.
    Okada TS (1980) Cellular metaplasia or transdifferentiation as a model for retinal cell differentiation. Curr Top Dev Biol 16: 349–80PubMedCrossRefGoogle Scholar
  13. 13.
    Okada TS, Yasuda K, Araki M, Eguchi G (1979) Possible demonstration of multipotential nature of embryonic neural retina by clonal cell culture. Dev Biol 68: 600–17PubMedCrossRefGoogle Scholar
  14. 14.
    Rezai KA, Lappas A, Farrokh-Siar L, Kohen L, Wiedemann P, Heimann K (1997) Iris pigment epithelial cells of Long Evans Rats demonstrate phagocytic activity. Exp Eye Res 65: 23–9PubMedCrossRefGoogle Scholar
  15. 15.
    Rezai KA, Lappas A, Kohen L, Wiedemann P, Heimann K (1997) Comparison of tight junction permeability for albumin in iris pigment epithelium and retinal pigment epithelium in vitro. Graefe’s Arch Clin Exp Ophthalmol 235: 48–55PubMedCrossRefGoogle Scholar
  16. 16.
    Scheider A, Giindisch O, Kampik A (1999) Surgical extraction of subfoveal choroidal new vessels and submacular hemorrhage in age-related macular degeneration: results of a prospective study. Graefe’s Arch Clin Exp Ophthalmol 237: 10–15PubMedCrossRefGoogle Scholar
  17. 17.
    Stanga PE, Kychenthal A, Fitzke FW, Halfyard AS, Chan R, Bird AC, Aylward GW (2002) Retinal pigment epithelium transplantation after choroidal neovascular membrane removal in age-related macular degeneration. Ophthalmology 109: 1492–8PubMedCrossRefGoogle Scholar
  18. 18.
    Thumann G (2002) Potential of pigment epithelium transplantation in the treatment of AMD. Graefe’s Arch Clin Exp Ophthalmol 240: 695–697PubMedGoogle Scholar
  19. 19.
    Thumann G, Aisenbrey S, Schraermeyer U, et al (2000) Transplantation of autologous iris pigment epithelium after removal of choroidal neovascular membranes. Arch Ophthalmol 118: 1350–5PubMedGoogle Scholar
  20. 20.
    Thumann G, Bartz-Schmidt KU, Schraermeyer U, Heimann K (1997) Descemets membrane as autologous membranous support in RPE/IPE transplantation. Curr Eye Res 16: 1236–8PubMedCrossRefGoogle Scholar
  21. 21.
    Thumann G, Bartz-Schmidt KU, El Bakri H, Schraermeyer U, Spee C, Cui J, Hinton DR, Ryan SJ, Heimann K (1999) Transplantation of autologous iris pigment epithelium to the subretinal space in rabbits. Transplantation 68: 195–201PubMedCrossRefGoogle Scholar
  22. 22.
    Thumann G, Bartz-Schmidt KU, Heimann K, Schraermeyer U (1998) Phagocytosis of rod outer segments by human iris pigment epithelial cells in vitro. Graefe’s Arch Clin Exp Ophthalmol 236: 753–7PubMedCrossRefGoogle Scholar
  23. 23.
    Thumann G, Kociok N, Bartz-Schmidt KU, Esser P, Schraermeyer U, Heimann K (1999) Detection of mRNA for proteins involved in retinol metabolism in iris pigment epithelium. Graefes Arch Clin Exp Ophthalmol 237: 1046–51PubMedCrossRefGoogle Scholar
  24. 24.
    Zhao S, Rizzolo LJ, Barnstable CJ (1997) Differentiation and transdifferentiation of the retinal pigment epithelium. Int Rev Cytol 171: 225–66PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 2004

Authors and Affiliations

  • Gabriele Thumann
    • 1
  • S. Aisenbrey
    • 2
  • K. U. Bartz-Schmidt
    • 3
  1. 1.Department of OphthalmologyUniversity of CologneGermany
  2. 2.Department of NeuroscienceTufts UniversityBostonUSA
  3. 3.University of TübingenTübingenGermany

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