Purpose: To explore neuroretinal transplantation in a large-animal model of severe retinitis pigmentosa, and to establish graft development, long-term survival, graft-host integration and effects on the host retina.Methods: Rhodopsin transgenic pigs, aged 6 months, in 1 eye received a fetal full-thickness neuroretinal sheet in the subretinal space by means of vitrectomy and retinotomy. Six months postoperatively, eyes were studied in the light microscope, and with immunohistochemical markers. Full-field ERG was performed at 4 and 6 months.Results: Laminated grafts with well organized photoreceptors, rod bipolar cells and Müller cells were found in 5 out of 6 eyes. Neuronal connections between graft and host retina were not seen. In the 5 eyes containing a graft, the number of surviving rods in the host retina was significantly higher compared with unoperated eyes. The ERG did not reveal any significant difference in b-wave amplitude between operated and control eyes, but the cone derived response in operated eyes increased significantly from 4 to 6 months while the rod response in control eyes decreased significantly.
Conclusions:Fetal full-thickness neuroretina can be transplanted safely to an eye with a severe retinal degeneration. In their major part, the transplants develop a normal laminated morphology and survive for at least 6 months. Graft and host retinal neurons do not form connections. Retinal function in the host is reduced initially by the surgical trauma but the presence of a well laminated graft counteracts this effect and rescues rods from degeneration.