Pigment epithelial detachment in the elderly

Pauleikhoff, Daniel; Löffert, D; Spital, Georg; Radermacher, Martin; Dohrmann, J; Lommatzsch, Albrecht; Bird, Alan C.

doi:10.1007/s00417-002-0505-8

Cited by 181 publications

(39 citation statements)

References 28 publications

(38 reference statements)

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“…In our setup, which was without a debridement because we primarily investigated the surgical safety of hESC-RPE transplantation, we did not encounter any Tcell mediated immunohistologic reaction from the host RPE or any fluid accumulation around the transplant, such as macular edema. In AMD the decline in hydraulic conductance of Bruch's membrane is very important; it may lead to RPE detachment and lipid accumulation [32,33]. One future experimental setup for our technique would be to incorporate RPE debridement to address various pitfalls, e.g., retinal bleb creation in atrophic regions, in human subretinal AMD surgery.…”

Section: Discussionmentioning

confidence: 99%

Subretinal implantation of a monolayer of human embryonic stem cell-derived retinal pigment epithelium: a feasibility and safety study in Yucatán minipigs

Koss

Falabella

Stefanini

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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Purpose A subretinal implant termed CPCB-RPE1 is currently being developed to surgically replace dystrophic RPE in patients with dry age-related macular degeneration (AMD) and severe vision loss. CPCB-RPE1 is composed of a terminally differentiated, polarized human embryonic stem cell-derived RPE (hESC-RPE) monolayer pre-grown on a biocompatible, mesh-supported submicron parylene C membrane. The objective of the present delivery study was to assess the feasibility and 1-month safety of CPCB-RPE1 implantation in Yucatán minipigs, whose eyes are similar to human eyes in size and gross retinal anatomy. Methods This was a prospective, partially blinded, randomized study in 14 normal-sighted female Yucatán minipigs (aged 2 months, weighing 24-35 kg). Surgeons were blinded to the randomization codes and postoperative and post-mortem assessments were performed in a blinded manner. Eleven minipigs received CPCB-RPE1 while three control minipigs underwent sham surgery that generated subretinal blebs. All animals except two sham controls received combined local (Ozurdex™ dexamethasone intravitreal implant) and systemic (tacrolimus) immunosuppression or local immunosuppression alone. Correct placement of the CPCB-RPE1 implant was assessed by in vivo optical coherence tomography and postmortem histology. hESC-RPE cells were identified using immunohistochemistry staining for TRA-1-85 (a human marker) and RPE65 (an RPE marker). As the study results of primary interest were nonnumerical no statistical analysis or tests were conducted. Results CPCB-RPE1 implants were reliably placed, without implant breakage, in the subretinal space of the minipig eye using surgical techniques similar to those that would be used in humans. Histologically, hESC-RPE cells were found to survive as an intact monolayer for 1 month based on immunohistochemistry staining for TRA-1-85 and RPE65. Conclusions Although inconclusive regarding the necessity or benefit of systemic or local immunosuppression, our study demonstrates the feasibility and safety of CPCB-RPE1 subretinal implantation in a comparable animal model and provides an encouraging starting point for human studies.

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Section: Discussionmentioning

confidence: 99%

Subretinal implantation of a monolayer of human embryonic stem cell-derived retinal pigment epithelium: a feasibility and safety study in Yucatán minipigs

Koss

Falabella

Stefanini

et al. 2016

Graefes Arch Clin Exp Ophthalmol

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“…The incidence is reported to be between 5 and 27% in the elderly [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]. Casswell et al [1] reported a spontaneous tear rate of vascular PEDs of 10%.…”

Section: Epidemiologymentioning

confidence: 99%

“…Retinal pigment epithelium (RPE) tears represent a rare complication in the treatment of patients with exudative AMD and frequently result in a devastating loss of visual acuity [1,2,3]. …”

Section: Introductionmentioning

confidence: 99%

Retinal Pigment Epithelium Tears: Risk Factors, Mechanism and Therapeutic Monitoring

2015

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Tears of the retinal pigment epithelium (RPE) are most commonly associated with vascularised RPE detachment due to age-related macular degeneration (AMD), and they usually involve a deleterious loss in visual acuity. Recent studies suggest an increase in RPE tear incidences since the introduction of anti-vascular endothelial growth factor (anti-VEGF) therapies as well as a temporal association between the tear event and the intravitreal injection. As the number of AMD patients and the number of administered anti-VEGF injections increase, both the challenge of RPE tear prevention and the treatment after RPE tear formation have become more important. At the same time, the evolution of retinal imaging has significantly contributed to a better understanding of RPE tear development in recent years. This review summarises the current knowledge on RPE tear development, predictive factors, and treatment strategies before and after RPE tear formation.

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“…Initially, most patients report distortion, metamorphopsia, or micropsia with relatively good vision; however, subsequent tearing of the retinal pigment epithelium (RPE), a disciform scar, or subretinal hemorrhage [5][6][7] may cause severe visual loss.…”

Section: Introductionmentioning

confidence: 98%

One-year results of combined photodynamic therapy and intravitreal bevacizumab injection for retinal pigment epithelial detachment secondary to age-related macular degeneration

Shima

Gomi

Sawa

et al. 2009

Graefes Arch Clin Exp Ophthalmol

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Pigment epithelial detachment in the elderly

Cited by 181 publications

References 28 publications

Subretinal implantation of a monolayer of human embryonic stem cell-derived retinal pigment epithelium: a feasibility and safety study in Yucatán minipigs

Subretinal implantation of a monolayer of human embryonic stem cell-derived retinal pigment epithelium: a feasibility and safety study in Yucatán minipigs

Retinal Pigment Epithelium Tears: Risk Factors, Mechanism and Therapeutic Monitoring

One-year results of combined photodynamic therapy and intravitreal bevacizumab injection for retinal pigment epithelial detachment secondary to age-related macular degeneration

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