Blind World

Retinitis Pigmentosa.
Vision Change After Sheet Transplant of Fetal Retina With Retinal Pigment Epithelium to a Patient With Retinitis Pigmentosa.

August 24, 2004.
Arch Ophthalmol. 2004;122:1159-1165.
Norman D. Radtke, MD; Robert B. Aramant, PhD; Magdalene J. Seiler, PhD; Heywood M. Petry, PhD; Diane Pidwell, PhD.

Objective To report the subjective and objective improvement in vision in a patient with autosomal dominant retinitis pigmentosa after transplantation of a sheet of fetal neural retina together with its retinal pigment epithelium.

Design A sheet of fetal neural retina with its retinal pigment epithelium was transplanted into the subretinal space under the fovea unilaterally in a patient with retinitis pigmentosa with visual acuity of 20/800 in the treated eye. Early Treatment Diabetic Retinopathy Study visual acuity testing, scanning laser ophthalmoscope, tissue typing of the donor and recipient, fluorescein angiography, multifocal electroretinogram, multifocal visually evoked potential, and clinical examination were used.

Results No clinical evidence of rejection was observed. There was no retinal edema or scarring. The transplant sheet lost its pigmentation by 6 months.

Main Outcome Measures A change in visual acuity from 20/800 to 20/400 (7 months), 20/250 (9 months), and 20/160 (1 year) was observed by Early Treatment Diabetic Retinopathy Study visual acuity testing. Independently, scanning laser ophthalmoscope testing at a different institution at 9 months showed a visual acuity of 20/270 at a 40 field of view.

Conclusion This study indicates that fetal retina transplanted with its retinal pigment epithelium can survive 1 year without apparent clinical evidence of rejection and show continued improvement in Early Treatment Diabetic Retinopathy Study visual acuity.

From the Retina Vitreous Resource Center, Norton Audubon Hospital (Drs Radtke and Aramant), the Departments of Anatomical Sciences and Neurobiology (Dr Aramant) and Ophthalmology and Visual Sciences and Psychological and Brain Sciences (Dr Petry), University of Louisville, Kentucky; Delany Retina Institute, Departments of Ophthalmology and Cell and Neurobiology, Keck School of Medicine, University of Southern California, Los Angeles (Dr Seiler); and the Tissue Typing Laboratory, Jewish Hospital, Louisville (Dr Pidwell). Drs Radtke, Seiler, and Aramant have a proprietary interest in the implantation instrument and procedure. None of the other authors or contributors has proprietary or financial interest in the technology or devices used in this study.

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