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Paolo G. Limoli, Enzo M Vingolo, Marcella Nebbioso, Sergio Zaccaria Scalinci, Luigi Mele, Celeste Limoli; BCVA changes after suprachoroideal graft of autologous cells in Dry AMD. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2259. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Our prior study (ARVO 2014, Medicine© 2014, in press) showed in eyes affected by Dry AMD a significant improvement of ERG data, recorded after the suprachoroidal autologous graft. We used three different types of autologous cells: adipocytes, present in the orbital fat dislocated in the suprachoroidal space, platelets, derivated from Platelet Rich Plasma (PRP) and adipose derived stem-cells (ADSCs), included in tissue adipose’s stromal vascular fractions (SVF), both grafted by suprachoroidal lipofilling. The study analyzes whether, in eyes affected by Dry AMD, the suprachoroidal graft of these cells can improve the BCVA over time.
We studied two groups of patients, both affected by Dry AMD, with BCVA equal to or greater than 1 logMAR.<br /> Group A consisted of 11 eyes of 8 patients (age average: 71.5 years), treated with autologous suprachoroidal graft by Limoli Retinal Restoration Tecnique (LRRT). Group B consisted of 14 eyes of 12 patients (age average: 80.4), used as a control variable. For each patient diagnosis has been verified by SD-OCT (Zeiss Cirrus) and microperimetry (Maia or MP1). Before the graft (T0), BCVA (Logmar) and close up visus (pts), maximal, scotopic and photopic ERG (μV), according to standard ISCEV, have been considered. BCVA was measured also at T90 and at T180.
In Group A, following LRRT, BCVA changed from 0.581 (T0) to 0.504 (T90) to 0.376 logM (T180) (+32.20%). In the control Group, BCVA changed from 0.573 (T0) to 0.587 (T90) to 0.601 logM (T180) (-4.75%). No negatives side effects occured in either case.
In patients with dry AMD who received LRRT treatment, BCVA can increase in six months, compared to the control group. All implanted cells can produce a lot of growth factors (bFGF, VEGF, PEDF, IL, M-CSF, GM-CSF, PlGF PDGF, ecc.), with neurotrophic and angiotrophic properties, ensuring a constant secretion of growth factors in a choroidal flow. From the choroidal layer, growth factors could reach retinal photoreceptors. Interaction with membrane receptors of retinal cells can activate an intracellular pathway. Consequently, we can have in the cell nucleus genic responses. We can obtain an antiapoptotic effect which can explain the neuroenhancement. This suggests a greater potential increase of BCVA in the grafted group.
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