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Manuel del Cerro, Mark S. Humayun, Srinivas R. Sadda, Jingtai Cao, Nobutsugu Hayashi, W. Richard Green, Constancia del Cerro, Eugene de Juan; Histologic Correlation of Human Neural Retinal Transplantation. Invest. Ophthalmol. Vis. Sci. 2000;41(10):3142-3148.
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purpose. To describe the histologic findings of the transplanted eye of a
94-year-old man with neovascular age-related macular degeneration, who
3 years earlier underwent subretinal transplantation of both a fetal
neural retinal sheet and a retinal microaggregrate suspension.
methods. Serial sections of the posterior segment of the eye and the
transplanted areas were processed and studied by routine histologic
techniques, including both light and transmission electron microscopy
(TEM). Transplanted areas were also examined for the presence of glial,
neuronal, and photoreceptor cell markers by standard
results. After transplantation in this patient, there was no visual improvement.
Light microscopic examination disclosed survival of the transplanted
cells in the subretinal space with no evidence of inflammation or
rejection. The neural retinal sheet transplant developed a layered
configuration. The retinal pigment epithelium (RPE) was absent over
much of the posterior pole, including the area of transplantation. TEM
examination and immunohistochemical analysis disclosed the presence of
neuronal and glial cells within the transplant. A few transplant
neuronal cell processes overlying a focus of residual RPE cells were
positive for S-antigen, but well-developed photoreceptor outer segments
were not present.
conclusions. Long-term survival of transplanted neural retinal tissue can be
achieved in human patients without immunosuppression. The lack of
photoreceptor development in this patient may be the result of absent
or dysfunctional RPE. Nonetheless, the long-term survival of grafted
tissue in the human subretinal space in the absence of
immunosuppressive treatment is promising for future efforts in the
field of neural retinal transplantation.
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