Transplantation of intact sheets of fetal neural retina with its retinal pigment epithelium in retinitis pigmentosa patients.
OBJECTIVE
To show the safety of transplanting sheets of fetal neural retina together with its retinal pigment epithelium (RPE) to patients with retinitis pigmentosa.


METHODS
Interventional case series.


METHODS
Sheets of fetal neural retina and RPE were transplanted together into the subretinal space near the fovea unilaterally in the eyes of five patients with retinitis pigmentosa who had only light perception in both eyes. The patients were followed for 6 months. The main outcome measures were tissue typing of both donors and recipients, fluorescein angiography, multifocal electroretinogram (mfERG) testing, and clinical examination. No immunosuppressive medications were given.


RESULTS
No evidence of rejection was observed. Up to 6 months there was no evidence of tissue disintegration, retinal edema, or scarring. There was no change in vision both by Snellen acuity and with mfERGs. Growth of the transplant was noted in two of five patients at 6 months vs. 2 weeks. All patients typed were HLA mismatched with donor tissue.


CONCLUSIONS
This study indicates that fetal retina can be transplanted together with its RPE and survive for at least 6 months without evidence of rejection. However, no improvements in vision were observed, possibly due to the severe retinal degeneration of the patients.
Radtke
Norman D
ND
Retina Vitreous Resource Center, Norton Audubon Hospital, Louisville, Kentucky 40217, USA. ret.vit-resource.ctr@prodigy.net
Seiler
Magdalene J
MJ
Aramant
Robert B
RB
Petry
Heywood M
HM
Pidwell
Diane J
DJ
D000328:Adult; D000368:Aged; D002470:Cell Survival; D004596:Electroretinography; D005260:Female; D016332:Fetal Tissue Transplantation; D005451:Fluorescein Angiography; D005865:Gestational Age; D006085:Graft Survival; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000166:cytology / Q000637:transplantation*; D012160:Retina / Q000166:cytology / Q000637:transplantation*; D012174:Retinitis Pigmentosa / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012449:Safety; D014792:Visual Acuity