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Paolo G. Limoli, Enzo Maria Vingolo, Marcella Nebbioso, Sergio Zaccaria Scalinci, Marco U Morales, Celeste S. S. Limoli; Cell surgery in retinitis pigmentosa: restoration and visual prognosis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):17.
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© ARVO (1962-2015); The Authors (2016-present)
Retinitis pigmentosa (RP) is a genetic disorder characterized by apoptosis and progressive loss of rods and than cones, eventually leading to retinal atrophy. The diagnosis is based on night blindness, decrease of visual field and extinct scotopic ERG.Until now, RP has no therapies and the better performance achieved by visual rehabilitation is affected by the progressive degeneration of photoreceptors.Recent studies enlight that growth factors released by cells can lead to retinal neuroenhancement, both by angiotrophic and neurotrophic action.Cell autograft is a new possible therapy for RP.LRRT is a suprachoroidal autograft with adipocytes, ADSCs from stromal vascular fractions and platelet-rich plasma that aims to enhance or preserve visual performances.Our pourpose is to highlight feasible prognostic criteria about therapeutic action of LRRT.
We performed a retrospective, observational clinical study to investigate visual prognosis of RP patient treated with LRRT.Inclusion criteria was RP without other eye diseases (cataract, macular pucker or disabling brain disorders).Each patient in T0 and in T180 was examined by performing a complete eye examination: BCVA in logMAR, residual and with magnification close-up visus in pts, sensitivity with Maia microperimetry in dB, foveal thickness (FT) by sdOCT in µ (T0) and ERG in µV (T0). ). Molecular diagnosis has not been performed.The tenets of the Declaration of Helsinki were observed, written informed consent and approval by the Ethics Committee of the Low Vision Academy was obtained.We included 35 eyes whose close-up visus was between 7 and 64 pts to avoid difficult evaluations for both low visus (> 64 pts) and normal, non-incremental visus (6 pts).According to FT, they were divided into Group A (8 n) ≤190 μ and Group B (13 n) > 190 μ.
After 6 months residual close-up visus in Group A goes from 25.88 to 26.13 pts (-0.97%; p> 0.5), in B from 15.15 to 12.00 pts (+20.79%; p< 0.5).Sensitivity in Group A goes from 5.45 to 6.29 dB (+15.41%; p> 0.5), in B from 3.15 to 4.18 dB (+ 32.70%; p< 0.5).Any patient can read better of 10 pts with proper device.We did not have any complications during surgery.
Eyes treated with LRRT showed a better increase of residual close-up visus and sensibility if FT is greater than 190 μ.FT dependent on residual cells is easily assessed by sdOCT and can be a prognostic criterion for patients undergoing LRRT treatment.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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