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D.A. Rabenlehner, B.V. Stanzel, S. Binder; RPE Wound Healing in Patients with AMD . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4629.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: Transplantation of autologous RPE cells might become a promising alternative treatment option for a number of retinal degenerations including AMD. The regenerative capacity of the aged autologous RPE graft material is still controversially discussed. Recently in vitro human PRE wound healing on different layers of Bruch's membrane of aged donors could be demonstrated by others. This study investigated patients with nasally debrided areas of RPE, which were created as a result of transplantig autologous RPE with our previously described techinque. Methods: Patients underwent subretinal surgery for fCNV due to AMD with simultaneous transplantation of autologous RPE. For RPE cell harvest, a bleb detschment was created with BSS (pt.1) and the RPE aspirated from 2–4 disc diameters (DD) with a special cannular. The nasal RPE monolayer defects were examined post operatively by fluorescein angiography, autofluorescence and red free images with a Heidelberg Retina Angiograph. Pictures were scaled and the extent of the RPE lesions was outlined to measure the areas during different observation times using ArchiCad–software. The patients were subdivided into group I with 2.9 months of mean follow up (up to 9 months) with immediately post OP data (i.e. 4 – 20 days) and group II with mean long term follow up (up to 28 months), however no immediately post OP data. Results: In the immediately postoperatively investigated group I (n=7), the monolayer defect showed a reduction to a certain extent in 50 % of the cases. In group II (n= 8) a reduction of the nasal RPE debrided areas was found in 14,5 % of the cases within 1 – 3 months postoperatively. Their initial examinations were between 4 weeks and 3 months. Both groups showed a mean reduction of the area of the RPE– defect by 14.5 % (10.4 – 20.0 %). The borders of the lesion remained constant after 2 months in both groups. Conclusions: These data show that in situ RPE wound healing in AMD occurs to a certain extend mostly within 4– 6 weeks after debridement. We however can not differentiate whether this phenomenon is related to RPE migration or proliferation.
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