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Paolo G. Limoli, Enzo M Vingolo, Sergio Zaccaria Scalinci, Marco U Morales, Celeste Limoli, ; ERG changes after suprachoroideal graft of autologous cells in AMD. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1457.
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Dry AMD has not a standard therapy yet.Since the 90’s, however, a series of studies about growth factors’s (GF) use designed to limit the retinal atrophy advance has begun. One of the suitable GF autologous sources is represented by adipose tissue.Other useful autologous sources are: platelets, derivable from Platelet Rich Plasma (PRP) and adipose derived stem-cells (ADSCs), included in tissue adipose’s stromal vascular fractions (SVF). They, surgically grafted into suprachoroidal space, might delay retinal cell apoptosis through an almost pharmacological modulation of their secretions.The aim of the work is to demonstrate, by ERG’s objectivity, an achievable therapeutic effect of the suprachoroidal graft of adipocytes, together ADSCs in SVF and PRP, able to generate growth factors.This technique is defined for convenience LMPT (Limoli modified Pelaez Technique).
We included retrospectively in the research 7 patients (12 eyes) suffering from dry AMD (medium age: 71,25 Range 62-80 years). Diagnosis has been verified for each patient by SD-OCT (Zeiss Cirrus) and microperimetry (Maia or MP1).Before the graft (t0), BCVA (Logmar) and close up (pts), maximal, scotopic and photopic ERG (μV), according to standard ISCEV, have been considered.Each eye has got an autologous cell graft through LMPT. One month later (t30), BCVA for distant and near vision, maximal, scotopic, photopic ERG have been reevaluated.
Functional changes following LMPT are: Scotopic ERG: from 41,26 to 60,83 μV (47,44% P<0,0005) Maximal ERG: from 112,22 to 129,68 μV (15,56% P<0,005) Photopic ERG: from 41,61 to 47,03 μV (13% P<0,05) BCVA: 0,78 logMAR (non-significant variation P>0,5) Close-up visus: from 29,5 to 28,42 pts (3,67% P>0,5).
During dry AMD foveal areas become atrophic with a big reduction of cones; extrafoveal areas, generally better preserved, keep a big number of rods.The decreased cones’s presence may clarify the non-significant increase of photopic ERG. The preserved number of rods may elucidate the significant increase of scotopic ERG. LMPT seems to have positive effects on ERG data increase, probably due to paracrine secretions properties of grafted autologous cells, some of which may be GF.In conclusion, ERG might be employed for monitoring trophic cell-teraphies’s effect objectively.
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