Vision change after sheet transplant of fetal retina with retinal pigment epithelium to a patient with retinitis pigmentosa.
OBJECTIVE
To report the subjective and objective improvement in vision in a patient with autosomal dominant retinitis pigmentosa after transplantation of a sheet of fetal neural retina together with its retinal pigment epithelium.


METHODS
A sheet of fetal neural retina with its retinal pigment epithelium was transplanted into the subretinal space under the fovea unilaterally in a patient with retinitis pigmentosa with visual acuity of 20/800 in the treated eye. Early Treatment Diabetic Retinopathy Study visual acuity testing, scanning laser ophthalmoscope, tissue typing of the donor and recipient, fluorescein angiography, multifocal electroretinogram, multifocal visually evoked potential, and clinical examination were used.


RESULTS
No clinical evidence of rejection was observed. There was no retinal edema or scarring. The transplant sheet lost its pigmentation by 6 months.


METHODS
A change in visual acuity from 20/800 to 20/400 (7 months), 20/250 (9 months), and 20/160 (1 year) was observed by Early Treatment Diabetic Retinopathy Study visual acuity testing. Independently, scanning laser ophthalmoscope testing at a different institution at 9 months showed a visual acuity of 20/270 at a 40 degrees field of view.


CONCLUSIONS
This study indicates that fetal retina transplanted with its retinal pigment epithelium can survive 1 year without apparent clinical evidence of rejection and show continued improvement in Early Treatment Diabetic Retinopathy Study visual acuity.
Radtke
Norman D
ND
Retina Vitreous Resource Center, Norton Audubon Hospital, KY, USA. ret-vit.resource.ctr@prodigy.net
Aramant
Robert B
RB
Seiler
Magdalene J
MJ
Petry
Heywood M
HM
Pidwell
Diane
D
D004596:Electroretinography; D005074:Evoked Potentials, Visual; D005260:Female; D016332:Fetal Tissue Transplantation; D005451:Fluorescein Angiography; D005799:Genes, Dominant; D006085:Graft Survival / Q000502:physiology; D006650:Histocompatibility Testing; D006801:Humans; D008875:Middle Aged; D009887:Ophthalmoscopy; D010857:Pigment Epithelium of Eye / Q000502:physiology / Q000637:transplantation*; D012160:Retina / Q000502:physiology / Q000637:transplantation*; D012174:Retinitis Pigmentosa / Q000235:genetics / Q000503:physiopathology / Q000601:surgery*; D014785:Vision, Ocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*