Functional analysis after auto iris pigment epithelial cell transplantation in patients with age-related macular degeneration

Recent transplantation studies indicate that subretinal space is not always an immunologically privileged site and non-autologous cells may be rejecte d in patients with exudative age-related macular degeneration (AMD). We per formed autologous iris pigment epithelial (IPE) cell transplantation by cel l suspension after autologous IPE cell culture in 8 patients with AMD. Thes e patients were followed without immunosuppression between 1.5 and 8 months and the retinal function was analyzed. No cystoid macular edema or fluores cein leakage was observed. Six of the 8 patients improved visual acuity of more than two lines and the other two patients retained preoperative visual acuity. Five patients had increased visual field sensitivity, one patient retained pretransplantation sensitivity, and one patient showed a gradual d ecrease in sensitivity (one patient was not examined). Although 2 of the 8 patients showed decreased amplitude of flicker electroretinography (ERG) (a bout 60 to 70% as that of preoperative level), the average improvement of e ach amplitude of a single white flash (a wave), photopic, or flicker ERG: w as 123, 102, and 107%, respectively. No proliferative change in the submacu lar lesion or vitreous cavity was observed after transplantation. From this functional analysis, transplanted autologous IPE may have, in part, an alt ernative function in regard to the retinal pigment epithelium in the subret inal space. (C) 1999 Tohoku University Medical Press.