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Paolo G. Limoli, Renzo Carpi, Filippo Tassi, Enzo M. Vingolo, Laura D'Amato, Enrico Giacomotti, Roberta Solari, Riccardo Di Corato; Adipocities Subscleral Implant. Growth Factors May Be Considered A New Therapy of Atrophic Retinal Pathology?. Invest. Ophthalmol. Vis. Sci. 2011;52(14):437.
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The objective of this study is to evaluate the influence of growth factors, conveyed by the insertion of a adipocities pedicle between sclera and choroid, on the visual performance compared to a group control. The basic theory of the intervention is based on the attitude of orbital adipocities, if dislocated, to produce large quantities of growth factors, particularly bFGF.Being a pedicle with self nutritional apport, these cells are kept alive continuing the secretion of bFGF.
We considered retrospectively 42 patients (76 eyes) suffering from atrophy pathologies of the retinal cells (hereditary dystrophies, age-related macular degeneration, optic nerve pathology). These patients were divided in two groups according to the acceptance of therapeutic proposal: Group A (20 eyes) performed the adipocities subscleral implant (ILS) and Group B (56 eyes) did not performed. For each eye was evaluated BCVA, residual visual acuity for near and sensitivity to Nidek microperimetry (MP1). The measurements were recorded for Group A at T0, T30, T90, T360 and T720, for Group B at T0, T180, T360 and T720.
From our experience in two years, BCVA has an improvement of 103.12% in treated cases compared with a fall of 5.74% in cases control. In two years the residual visual acuity for near has an improvement of 3.02% in treated cases compared with a fall of 9.64% in cases control, and the sensitivity analyzed by MP1 has an improvement of 62.81% in treated cases compared to an improvement of 40.88% in cases control. he explanation of the improvement of retinal sensitivity in the cases control is due to antiapoptotic and rehabilitative treatments associated.
Patients who received the ILS have a more favorable evolution than the natural history of atrophic diseases of the retina. The secretion of growth factors in choroidal space has proven capable of slowing the retinal apoptosis and the visual performances increased as consequence of the better retinal trophism.
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