Subretinal Transplant of Human Amniotic Membrane in Advanced Age-Related Macular Degeneration

• Published in: Life (Basel, Switzerland) Vol. 12; no. 12; p. 1998
• Main Authors: Caporossi, Tomaso, Scampoli, Alessandra, Baldascino, Antonio, Gambini, Gloria, Pacini, Bianca, Governatori, Lorenzo, Bacherini, Daniela, Carlà, Matteo Mario, Crincoli, Emanuele, Rizzo, Clara, Kilian, Raphael, Rizzo, Stanislao
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.11.2022; MDPI
• Subjects: Acuity; Age; Age related diseases; age-related macular degeneration; Amnion; Amniotic membrane; Amniotic sac; Angiography; Atrophy; Care and treatment; Complications; Epithelium; Extracellular matrix; Eye; Eye diseases; Growth factors; Health aspects; Homeopathy; human amniotic membrane; Immunology; Laboratories; Macular degeneration; macular neovascularization; Materia medica and therapeutics; Medical imaging; Medical research; Medical treatment; Medicine, Experimental; Membranes; Methods; OCT-angiography; Photoreceptors; Physiological aspects; Pluripotency; Postoperative; regenerative ophthalmology; Retina; Retinal detachment; Retinal pigment epithelium; Statistical analysis; Stem cells; Surgery; Tamponade; Therapeutics; Transplantation of organs, tissues, etc; Variance analysis; Vascularization; Visual acuity; Italy; Fort Worth Texas; United States > US; Germany; OCT-angiography; stem cells; regenerative ophthalmology; macular neovascularization; human amniotic membrane; vitrectomy; age-related macular degeneration
• DOI: 10.3390/life12121998
• ISSN: 2075-1729

Macular neovascularization (MNV) and geographic atrophy can complicate age-related macular degeneration (AMD) and lead to severe visual acuity reduction. Despite the medical treatments available, with a defect in the retinal pigmented epithelium (RPE) there is no possibility of restoring acceptable visual acuity. We evaluated postoperative outcomes in patients affected by advanced AMD who underwent subretinal implant of the human amniotic membrane (hAM) as a source of pluripotent stem cells. This retrospective, consecutive, non-randomized interventional study included 23 eyes of 21 patients affected by AMD complicated by MNV, and five eyes of five patients affected by geographic atrophy. All eyes underwent a pars plana vitrectomy, neovascular membrane removal for the MNV group, a subretinal implant of hAM, and gas tamponade, and were followed for 12 months. The primary study outcome was visual acuity improvement. Secondary outcomes were postoperative complications, OCT-angiography parameters correlated with best-corrected visual acuity (BCVA) and MNV recurrence. The mean preoperative BCVA was 1.9 logMAR, and the mean final BCVA value was 1.2 logMAR. In the MNV group, the mean BCVA improved from 1.84 logMAR to 1.26 logMAR, and from 1.84 logMAR to 1.32 logMAR in the geographic atrophy group. No MNV recurrence was evident in 12 months of follow-up. An OCT-angiography scan was used to evaluate the retinal vascularization in the treated eye, which showed a high correlation between BCVA and deep vascular density. This study demonstrates the hAM potential and safety in promoting a partial restoration of retinal function together with an increase in visual acuity.