Stem Cell Ophthalmology Treatment Study: bone marrow derived stem cells in the treatment of non-arteritic ischemic optic neuropathy (NAION)

Weiss, Jeffrey N.; Levy, Steven; Benes, Susan C.

doi:10.21037/sci.2017.11.05

Cited by 38 publications

(38 citation statements)

References 39 publications

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“…[ 9 , 10 ] Other factors, such as enhanced intraocular pressure, blood hypercoagulable state, and hypotension have also been related to the ION, which belong to the nonarteritic ION. [ 11 ] The underlying mechanism of ION involves the failure of cellular energy due to the insufficient blood flow. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of ischemic optic neuropathy caused by dissection of the internal carotid artery

Zheng

Wang²,

Chen³

et al. 2020

Medicine

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Rationale: Ischemic optic neuropathy (ION), due to diseases of the arteries supplying the optic nerve, is an ischemic damage of the optic nerve. This report highlights a case with monocular decreasing visual acuity caused by dissection of the internal carotid artery (ICA), which is a relatively rare cause for ION. Patient concerns: A 44-year-old woman presented with a decreasing visual acuity and defected visual field in the right eye for 1 week. The best corrected visual acuity (BCVA) was 20/400 in the right eye, and 20/20 in the left eye. In the right eye, the pupil showed little reaction to light with a relative afferent pupillary defect. The visual field test disclosed a defect in the inferior field connecting to the blind spot. Electroretinogram recording showed no obviously declined retinal function. No recognizable waveforms were presented in pattern visual–evoked potential (PVEP) examination, whereas the flash visual–evoked potential result revealed a delayed peak time and a reduced amplitude of P2-wave. Diagnosis: The patient was diagnosed as ION with the aid of computed tomographic angiography of the brain and neck, which revealed a stenosis in the right ICA and an occlusion in the right cerebral middle artery. The stenosis was verified as dissection of the ICA by digital subtraction angiography. Interventions: Based on the clinical findings, stent implantation inside the right ICA was performed. Outcomes: The ICA was recanalized soon and the BCVA of the right eye was improved to be 20/25 five months later. A second PVEP examination revealed a recognizable waveform in the right eye, although the peak time and amplitude of the P100-wave was a bit abnormal compared to that of the left eye. Lessons: ION with the sign of decreasing monocular visual acuity could occur due to dissection of the ICA, with no obvious neurologic symptom at the beginning. The present case emphasizes the importance of suspicion of ICA problems as the underlying cause for ION, which could help to take in-time measure to save the vision and avoid further complications.

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Section: Discussionmentioning

confidence: 99%

Diagnosis of ischemic optic neuropathy caused by dissection of the internal carotid artery

Zheng

Wang²,

Chen³

et al. 2020

Medicine

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“…Potential retreatment may again result in improvement and a return of vision to an earlier time in the disease course. Most recently the authors published statistically positive data on a degenerative condition affecting the optic nerve called Non-arteritic Ischemic Optic Neuropathy (NAION) with 80% of patients achieving binocular improvement and 73.6% of eyes gaining vision (P=0.019) (22). It appears that retinal and neurologic tissue can respond positively to BMSC intervention.…”

Section: Discussionmentioning

confidence: 99%

Stem Cell Ophthalmology Treatment Study: bone marrow derived stem cells in the treatment of Retinitis Pigmentosa

Weiss¹,

Levy²

2018

Stem Cell Investig.

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The BMSC protocols of the SCOTS achieved meaningful visual acuity improvements or stability in RP that were of statistical significance. Duration of disease did not appear to affect the ability of eyes to respond. Safety was confirmed. Possible mechanisms by which improvement occurred may include transdifferentiation of BMSC into Neuronal Nuclei (NeuN) positive cells, BMSC paracrine secretions or neurotrophic factors and hormones, transfer of mitochondria, release of messenger RNA or other compounds via exosomes or microvesicles. Given the successful outcome in this otherwise progressive condition, consideration should be given to providing this treatment option.

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“…The inclusion and exclusion patient criteria for SCOTS have been presented repeatedly in a number of prior published papers [6][7][8][9][10]. They are reiterated here to facilitate the readers' access:…”

Section: Methodsmentioning

confidence: 99%

“…Patients with ETDRS visual acuities less than 5/200 were checked for the ability to perceive hand motions. Patients who could only perceive light or not perceive light were recorded as "light perception" or "no light perception", respectively [6][7][8][9][10].…”

Section: Exclusion Criteria Includementioning

confidence: 99%

Stem Cell Ophthalmology Treatment Study (SCOTS): Bone Marrow-Derived Stem Cells in the Treatment of Age-Related Macular Degeneration

Weiss

Levy²

2020

Medicines

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Background: Dry age-related macular degeneration (AMD) is one of the leading causes of vision loss in older patients. The macula accumulates drusen with loss of retinal pigment epithelial cells and photoreceptors. Abnormal subretinal neovascularization is absent. There is no effective drug therapy for dry AMD and a large proportion of patients progress to legal blindness from macular atrophy. The Stem Cell Ophthalmology Treatment Study (SCOTS) was conducted to assess the effect of bone marrow-derived stem cells (BMSCs) on dry AMD and other retinal and optic nerve diseases. Methods: Thirty-two eyes were treated with BMSC per the protocols in SCOTS. Provision of BMSCs in Arm 1 was via retrobulbar (RB), sub-tenons (ST) and intravenous (IV); Arm 2 via intravitreal, RB, ST and IV; Arm 3 via subretinal and IV. Patient age averaged 78 years old and ranged from 69 to 90. Visual acuity preoperatively ranged from counting fingers to 20/50-2 with an average preoperative LogMAR of 1.125. Results: Following treatment, 20 of 32 (63%) of eyes experienced improvement in visual acuity averaging 27.6% on LogMAR and ranging from 2.5% to 44.6%. The mean improvement in LogMAR was 0.963 with a standard deviation (SD) of 0.42. The visual acuity remained stable in 34% of treated eyes. One eye continued to worsen as a consequence of disease progression. The results showed high statistical significance with p ≤ 0.001. The procedures were conducted safely, and no complications were observed. Conclusion: Treatment of dry AMD with BMSC using the protocols developed in the SCOTS clinical trial has shown statistically significant clinical benefit improving visual acuity and potentially delaying visual loss in the disease.

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Stem Cell Ophthalmology Treatment Study: bone marrow derived stem cells in the treatment of non-arteritic ischemic optic neuropathy (NAION)

Cited by 38 publications

References 39 publications

Diagnosis of ischemic optic neuropathy caused by dissection of the internal carotid artery

Diagnosis of ischemic optic neuropathy caused by dissection of the internal carotid artery

Stem Cell Ophthalmology Treatment Study: bone marrow derived stem cells in the treatment of Retinitis Pigmentosa

Stem Cell Ophthalmology Treatment Study (SCOTS): Bone Marrow-Derived Stem Cells in the Treatment of Age-Related Macular Degeneration

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