Advances in biomaterials as a retinal patch for the repair of rhegmatogenous retinal detachment

Abstract

Rhegmatogenous retinal detachment (RRD) is the most common retinological emergency that can cause blindness without surgical treatment. RRD occurs when liquefied vitreous accumulates between the neurosensory retina and the retinal pigment epithelium via retinal breaks, which are caused by the separation of the vitreous from the retina with aging. Currently, the main treatment option is pars plana vitrectomy, which involves surgical removal of the vitreous and laser photocoagulation around retinal breaks to generate firm chorioretinal adhesion, as well as subsequent filling of the vitreous cavity with long-lasting substitutes (expansile gas or silocone oil) to prevent the connection between the subretinal space and the vitreous cavity via the breaks before the chorioretinal adhesion firm enough. However, the postoperative face-down position and the not very satisfactory first retinal reattachment rate place a heavy burden on patients. With the development of technology and materials engineering, researchers have developed biomaterials that can be used as a retinal patch to seal retinal breaks and prevent the connection of subretinal space and vitreous cavity via breaks, thus replacing the long-lasting vitreous substitutes and eliminating the postoperative face-down position. Preclinical studies have demonstrated that biomaterial sealants have enough biocompatibility and efficacy in the in vitro and in vivo experiments. Some sealants have been used in clinical trials on a small scale, and the results indicate promising application prospects of the biomaterial sealants as retinal patches in the repair of RRD. Herein, we review the recent advances in biomaterials as retinal patches for the repair of RRD, focusing on the biomaterial categories, methods, and procedures for sealing retinal breaks, as well as their biocompatibility and efficacy, current limitations, and development perspectives.

Extracellular Vesicles in the Repair of Bone and Cartilage Injury: From Macro‐Delivery to Micro‐Modification

“…Therefore, the exosome engineering strategy may greatly help treat clinical osteoarthritis in the future. [187] In addition to the direct genetic modifications of parental cells to obtain EVs that express multiple nucleic acids, appropriate regulation of the culture conditions of parental cells can also enhance the overexpression of certain miRNAs targeting bone and cartilage regeneration, resulting in biological effects similar to those of cell transfection. Shen et al performed the hypoxic preconditioning of BMSCs.…”

“…used miR‐212‐5p mimics to transfect synovial MSCs and detected the upregulation of miR‐212‐5p expression in secreted exosomes. [ 187 ] Further experiments showed that the miR‐212‐5p‐overexpressed exosomes significantly inhibited IL‐1β‐induced chondrocyte degeneration and inflammatory response, and excessive chondrocyte degeneration and inflammation are often the representative pathological manifestations of osteoarthritis. Therefore, the exosome engineering strategy may greatly help treat clinical osteoarthritis in the future.…”

“…Therefore, the exosome engineering strategy may greatly help treat clinical osteoarthritis in the future. [ 187 ]…”

Innovative Strategies for Drug Delivery to the Ocular Posterior Segment

“…In vivo investigation with fibrin hydrogels revealed high short-term subretinal biocompatibility of this type of DDS, which is a suitable scaffold for human Embryonic Stem Cell- Derived Retinal Pigment Epithelial Cells (hESC-RPE) transplantation, which could be a new grafting material for tissue engineering RPE cells [ 206 ]. A small series of rhegmatogenous retinal detachment models with short-term follow-up provide preliminary evidence to support the favorable biocompatibility and efficacy of the hyaluronic acid (HA) hydrogel as a promising retinal patch for sealing retinal breaks in retinal detachment repair [ 207 ]. Moreover, gene delivery using an injectable hydrogel has also been studied as a treatment for retinitis pigmentosa [ 208 , 209 ].…”

Quantitative Microvascular Change Analysis Using a Semi-Automated Software in Macula-off Rhegmatogenous Retinal Detachment Assessed by Swept-Source Optical Coherence Tomography Angiography

“…Despite the technical advances in retinal surgery, RRD is considered a sight-threatening condition and must be treated as quickly as possible [2][3][4]. Additionally, after having achieved a good anatomical retinal reattachment, the postoperative visual acuity (VA) gain is often incomplete in many subjects [1][2][3][4][5][6].…”