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News Update Service
Saturday, July 12, 2008 : 1100 Hrs       
Sci. & Tech.
Retina transplants show promise in patients with retinal degeneration 

Experimental technique yields improved vision in 7 of 10 patients, reports 
American Journal of Ophthalmology. 

Philadelphia: Preliminary research shows encouraging results with 
transplantation of retinal cells in patients with blindness caused by retinitis 
pigmentosa
(RP) and age-related macular degeneration (AMD), according to a report in the 
August issue of American Journal of Ophthalmology (http://www.AJO.com). 

In the FDA-monitored study, Dr. Norman D. Radtke of University of Louisville, 
Ky., lead author of the study and colleagues performed the experimental 
transplant
procedure in ten patients with vision loss resulting from retinal degeneration: 
six patients with RP and four with the "dry" form of AMD. Although they
have different causes, both RP and AMD lead to destruction of the 
light-receiving (photoreceptor) cells of the retina. There is currently no 
effective
treatment for recovery of visual loss from either condition. 

All patients underwent transplantation of fetal retinal cells. The cells were 
implanted along with their attached retinal pigment epithelium, which plays
a key role in nourishing the photoreceptor cells. The concept behind the 
experimental procedure was that the new cells would grow to replace the damaged
photoreceptor cells, connecting to the patient's remaining retina. 

Follow-up testing showed visual improvements in seven of the ten patients: 
three of the patients with RP and all four patients with AMD. Although vision
remained in the "legally blind" range for all patients, the gains in vision 
were significant and measurable. 

"This clinical evidence shows the promise of our method to alter progressive 
vision loss due to incurable degenerative diseases of the retina," comments
Dr. Radtke. 

In one patient with RP, the visual improvement was still present up to six 
years after surgery, while vision in the opposite (untreated) eye continued to
deteriorate. In the same patient, specialized tests showed a 27 percent 
increase in light sensitivity in the treated eye. 

There were no problems with rejection of the transplants by the patients' 
immune systems, despite the lack of a perfect immunological match between the
transplant donors and recipients. This likely reflected the special 
"immunologic protection" of tissues within the eye. Two patients also had 
improved
vision in the untreated eyes. The reason for this unexpected result is unknown, 
but may involve some effect of transplantation on the immune system. 

The experimental transplant procedure was designed on the basis of animal 
studies showing that transplantation of retinal cells can lead to the 
development
of new retinal tissues. Previous "phase I" studies established the safety of 
the procedure. The new "phase II" trial provides the first evidence of improved
vision-the first treatment of any type to restore lost vision in patients with 
RP or AMD. 

Much further research will be needed to determine the potential for retinal 
transplantation to improve vision in patients with these diseases. "Retinal
implants that combine retina and retinal pigment epithelium demonstrated an 
apparent ability to integrate with host retinas and to re-establish the visual
pathways interrupted by disease," adds Dr. Radtke. "What we have learned will 
help us to refine this method and obtain further evidence that retinal implants
may be a viable therapy for retinal degenerative disease." 


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