Preliminary report: Indications of improved visual function after retinal sheet transplantation in retinitis pigmentosa patients

PURPOSE: To report indications of new visual function after retinal transpl antation in two blind patients with retinitis pigmentosa. METHODS: Intact sheets of fetal retina (15 and 17 weeks gestational age) we re transplanted subretinally (between the neurosensory retina and the retin al pigment epithelium) near the fovea in the left eye of a 23-year-old whit e man (Patient A) and in the left eye of a 72-year-old white woman (Patient B), both with autosomal-recessive retinitis pigmentosa. RESULTS: Postoperatively, at 6 and 5 months, respectively, both patients re ported new visual sensation in the visual field corresponding to the transp lant. In both patients, the visual sensation continued to be present after transplantation, at 12 and 8 months, respectively. In Patient A, a transien t multifocal electroretinography (mfERG) response was observed in the trans plant area 4 months postoperatively but was not detectable in Patient A at 6.0 and 9.5 months post-retinal transplantation. In Patient B, no positive mfERG responses were seen up to 5 months postoperatively, No rejection (pre senting as cystoid macular edema, macular pucker, and extensive intraretina l edema with disrupted retinal pigment epithelium) to the transplanted tiss ue was seen up to 13 months in Patient A and 9 months in Patient B by fluor escein angiography. CONCLUSION: Transplantation of intact sheets of fetal human retina in two p atients with retinitis pigmentosa was not associated with evidence of trans plant rejection. Subjective improvement and an indication of objective impr ovement 4 months postoperatively were seen in Patient A, and subjective imp rovement only was seen in Patient B. (Am J Ophthalmol 1999;128:384-387. (C) 1999 by Elsevier Science Inc. All rights reserved.).