American Journal of Ophthalmology
Volume 133, Issue 2 , Pages 215-225 , February 2002

Transplantation of autologous retinal pigment epithelium in eyes with foveal neovascularization resulting from age-related macular degeneration: a pilot study

  • Susanne Binder, MD

      Affiliations

    • Corresponding Author InformationReprint requests to Susanne Binder, MD, Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic, Juchgasse 25, A 1030 Vienna, Austria; fax: 0043-1-71165/4609
    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Ulrike Stolba, MD

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Ilse Krebs, MD

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Lukas Kellner, MD

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Christian Jahn, MD

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Hans Feichtinger, MD

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Margit Povelka, MD

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Ursula Frohner, CN

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Andreas Kruger, MD

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Ralf-Dieter Hilgers, MS

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria
  • ,
  • Walter Krugluger, MD

      Affiliations

    • Department of Ophthalmology, The Ludwig Boltzmann Institute of Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic (S.B., U.S., I.K., L.K., C.J., U.F.), Vienna, Austria; Institute of Pathology and Bacteriology, Rudolf Foundation Clinic (H.F.), Vienna, Austria; Institute for Histology and Embryology, Department of Cellbiology and Ultrastructioral Research, University Clinic (M.P.), Vienna, Austria; University Eye Clinic Vienna, AKH, Währinger Gürtel 18-20 (A.K.), Vienna, Austria; Institute for Biometrie, Rheinisch-Westfälische Technische Hochschule Aachen (R.-D.H.), Germany; and Institute of Clinical Chemistry, Rudolf Foundation Clinic (W.K.), Vienna, Austria

,Accepted 1 November 2001.

References 

  1. Thomas M, Dickinson J, Melberg N, et al.  Visual results after surgical removal of subfoveal choroidal neovascular membranes. Ophthalmology. 1996;101:1384–1396
  2. Scheider A, Gündisch O, Kampik A. Surgical extraction of subfoveal new vessels and submacular haemorrhage in AMD; results of a prospective study. Graefes Arch Clin Exp Opthalmol. 1998;237:10–15
  3. Castellarin AA, Nasir M, Sugino IK, et al.  Progressive presumed choriocapillaris atrophy after surgery for age related macular degeneration. Retina. 1998;18:139–149
  4. Nasir MA, Sugino IK, Zarbin MA, et al.  Decreased choriocapillaris perfusion following surgical excision of choroidal NVM in age-related macular degeneration. Br J Ophthalmol. 1997;81:481–489
  5. Alessandro A, Castellarin MD, Nasir M, et al.  Progressive presumed choriocapillaris athrophy after surgery for AMD. Retina. 1998;18:143–149
  6. Turner JE, Blair JR. Newborn rat retinal cells transplanted into a retinal lesion site in adult host eyes. Brain Res. 1986;391:91–104
  7. del Cherro M, Notter MF, del Cherro C, et al.  Intraretinal transplantation for rod-cell replacement in light damaged retinas. J Neural Transplant. 1998;1:1–10
  8. Silvermann MS, Huges SE. Transplantation of photoreceptors to light damaged retinas. Invest Ophthalmol Vis Sci. 1989;30:1684–1690
  9. Kaplan HJ, Tetzel TH, Berger AS. Human photoreceptor transplantation in retinitis pigmentosa. A safety study. Arch Ophthalmol 1997;115:1186–1172.
  10. Algvere PV, Berglin L, Gouras P, et al.  Transplantation of fetal retinal pigment epithelium in age- related macular degeneration with subfoveal neovascularisation. Graefes Arch Clin Exp Ophthalmol. 1994;232:707–716
  11. Durlu YK, Tamai M. Transplantation or retinal pigment epithelium using viable cryopreserved cells. Cell Transplant. 1997;6:149–162
  12. Algvere PV, Berglin L, Gouras P, et al.  Transplantation of RPE in age-related macular degeneration; observations in disciform lesions and dry atrophy. Graefes Arch Clin Exp Opthalmol. 1997;149–158
  13. Algvere PV, Dafgard Kopp EME, Gouras P. Long-term outcome of RPE allografts in non-immuno suppressed patients with AMD. Eur J Ophthalmol. 1999;9:217–230
  14. Grisanti S, Misaki I, Kosiewitcz M, et al.  Immunity and immune privilege elicited by cultured retinal pigment epithelial cell transplants. Invest Ophthalmol Vis Sci. 1997;38:1619–1626
  15. Gabrielan K, Oganesian A, Patel SC, et al.  Cellular response in rabbit eyes after human fetal RPE transplantation. Graefes Arch Clin Exp Ophthalmol. 1999;237:326–335
  16. Mashhour P, Renard G. Iris pigment epithelium autotransplantaton in exudative ARMD. Invest Ophthalmol Vis Sci 1997;38:4:657–663.
  17. Thumann G, Bartz-Schmidt KU, Heimann K, et al.  Phagocytosis of rod outer segments by human iris pigment epithelial cells in vitro. Graefes Arch Clin Exp Ophthalmol. 1998;236:753–757
  18. Tamai M, Abe T, Tomita H, et al.  Autologous iris pigment transplantation in age related macular degeneration. In:  Das T editors. Retina. Current Practice and Future Trends. Hyderabad: PARAS publishing; 1999;p. 151–161
  19. Dintelmann T, Heimann K, Kayatz P, et al.  Comparative study of ROS degradation by IPE and RPE cells in vitro. Graefes Arch Clin Exp. 1999;237:830–839
  20. Klein R. Epidemiology. In:  Berger JW,  Fine St L,  Maguire MG editor. Age-related macular degeneration. St. Louis, MO: M. Mosby; 1999;p. 31–55
  21. International ARMD Epidemiological Study Group . An international classification and grading system for age-related maculopathy and macular degeneration. Surv Ophthalmol. 1995;39:367–374
  22. Macular Photocoagulation Study Group . Argon laser photocoagulation for neovascular maculopathy (five year result from randomised clinical trial). Arch Opthalmol. 1991;109:1109–1114
  23. Ferris FLD, Kassoff A, Bresnick GH, et al.  New visual acuity charts for clinical research. Am J Ophthalmol. 1982;94:91–96
  24. Holm S. A simple sequentially rejective multiple test procedure. Scand J Statistics. 1979;6:65–70
  25. SAS, Inc. SAS/STAT user’s guide, version 6. Cary, NC: SAS Institute, Inc, 1990.
  26. Assadoulina A, Feichtinger H, Binder S. Obtaining and quantification of RPE-cells from donor eyes using the Cell Tram Oil Microinjection pump. Der Ophthalmologe. 2001;98:1; (Abstract)
  27. Solbach U, Keilhauser C, Knabben H, et al. Imaging of retinal autofluorescence in patients with age-related macular degeneration. Retina 1997;17:5:385–389.
  28. Rückmann A, Fitzke F, Bird AC. Distribution of pigment epithelium autofluorescence in retinal disease state recorded in vivo and its change over time. Graefes Arch Clin Exp Opthalmol. 1999;237:1–9
  29. Holz FG. Autofluoreszenz Imaging der Makula. Der Ophthalmologe. 2001;98:10–18
  30. Lopez PE, Grossniklaus HE, Lambert HM, et al.  Pathologic features of surgically excised neovascular membranes in age-related macular degeneration. Am J Ophthalmol. 1991;112:647
  31. Gass JDM. Biomicroscopic and histopathologic considerations regarding the feasibility of surgical excision of subfoveal neovascular membranes. Am J Ophthalmol. 1994;118:285–298
  32. Panda-Jonas S, Jonas JB, Jacobczyk-Zmijy M, et al.  Retinal pigment epithelial cell count, distribution and correlations in normal human eyes. Am J Ophthalmol. 1996;121:181–189
  33. Tezel TH, Kaplan H, del Priore LV. Fate of human retinal pigment epithelial cells seeded onto layers of human Bruch’s membrane. Invest Ophthalmol Vis Sci 1999;40:2:467–476.
  34. Craford S, Algvere PV, Kopp ED. Cyclosporine treatment of RPE allografts in the rabbit subretinal space. Acta Ophthalmol Scand. 2000;78:122–129
  35. Humayun MS, de Juan E, del Cerro M. Human neural retinal transplantation. Invest Ophthalmol Vis Sci 2000;3100–3106.
  36. Peyman GA, Blinder KJ, Paris KJ, et al.  A technique for retinal pigment epithelial transplantation for age-related macular degeneration secondary to extensive subfoveal scarring. Ophthalmic Surg. 1991;22:102–108
  37. Awylard GW, Kychenthal A, Stanba PE, et al. RPE transplantation. A new surgical technique for treatment of choriodal NV in AMD. 12th Annual Meeting of the Retina Society, Regensburg, Germany, July 9–10, 1999.
  38. Stanga PE, Kychenthal A, Fitzke FW, et al. Retinal pigment epithelium translocation and central visual function in AMD. Oral presentation, Club Jules Gonin, September 2–6, 2000, Taormina, Italy.
  39. Machemer R, Steinhorst R. Retinal separation, retinotomy and macular relocation, a surgical approach for age related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 1993;231:635–641
  40. Eckardt C, Eckart U, Conrad HC. Macular rotation with and without counter rotation of the globe in patients with age related macular degeneration. Graefes Arch Clin Exp Ophthalmol. 1999;237:313–325
  41. de Juan E, Löwenstein A, Bressler N, et al.  Translocation of the retina for management of subretinal neovascularisation. Am J Ophthalmol. 1998;125:635–646
  42. Wiedemann P, Faude F, Jochmann C, et al.  Begrenzte Translokation der Makula bei subfovealer choroidaler Neovaskularisation. Spektrum der Augenheilkunde. 2000;14:254–258
  43. Thumann G, Aisenbrey S, Schraemeyer U, et al.  Transplantation of autologous iris pigment epithelium after removal of choroidal neovascular membranes. Arch Ophthalmol. 2000;118:1350–1355
  44. Macular Photocoagulation Study Group . Persistent and recurrent neovascularisation after laser photocoagulation for subfoveal choroidal neovascularisation of age-related macular degeneration. Arch Ophthalmol. 1994;112:489–499
  45. Omerod LD, Puklin JE, Frank RE. Long-term outcomes after surgical removal of advanced subfoveal neovascular membranes in age-related macular degeneration. Ophthalmology. 1994;101:1201–1210
  46. Seaton AD, Turner JE. RPE transplants stabilize retinal vasculature and prevent neovascularisation in the RCS rat. Invest Ophthalmol Vis Sci. 1992;33:83–89
  47. Seaton AD, Sheedlo HJ, Turner JE. A primary role for RPE transplants in the inhibition and regression of neovascularisation in the RCS rat. Invest Ophthalmol Vis Sci. 1994;35:162–169
  48. Binder S, Stolba U, Krebs I, et al.  Zur Transplantation autologer Pigmentepithelzellen. Spektrum der Augenheilk. 2000;14:249–253

PII: S0002-9394(01)01373-3

American Journal of Ophthalmology
Volume 133, Issue 2 , Pages 215-225 , February 2002