Human Amniotic Membrane Plug to Restore Age-Related Macular Degeneration Photoreceptor Damage

Stanislao Rizzo, Tomaso Caporossi*, Ruggero Tartaro, Lucia Finocchio, Bianca Pacini, Daniela Bacherini, Gianni Virgili

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Age-related macular degeneration (AMD) is the leading cause of legal blindness in adults 65 years of age and older. Choroidal neovascularization (CNV) can complicate AMD and lead to severe visual acuity reduction. Despite the several treatments available, if the retinal pigment epithelium is damaged, we have to cope with the impossibility of restoring acceptable visual acuity using only medical treatments. Design: Prospective, consecutive, interventional study. Participants: Eleven patients affected by AMD, 6 patients affected by CNV, and 5 patients affected by geographic atrophy. Methods: All patients underwent a pars plana vitrectomy with subretinal implantation of human amniotic membrane (hAM) to induce photoreceptor regeneration and partial visual acuity restoration. Main Outcome Measures: Primary study outcome was visual acuity improvement. Secondary outcomes were multimodal imaging results. Results: Mean preoperative best-corrected visual acuity (BCVA) was 20/2000 (2 logarithm of the minimum angle of resolution [logMAR]), and all the patients showed a BCVA of counting fingers or less. Mean final BCVA was 20/400 (1.31 logMAR), ranging from 20/2000 to 20/100 (2–0.7 logMAR). OCT angiography was used to measure retinal vascularization in the treated eye compared with the fellow eye. A high correlation between BCVA and deep vascular density was evidenced. Adaptive optics findings, obtained over the retinal area where the highest functionality was observed, were evaluated using microperimetry. The images showed possible photoreceptor presence over the hAM membrane. Conclusions: This work supports the feasibility and safety of the hAM to promote partial retinal function restoration 6 months after surgery with visual acuity improvement. The advanced diagnostics help to understand the interaction between the hAM and photoreceptors and suggest that photoreceptor regeneration may occur.

Original languageEnglish
Pages (from-to)996-1007
Number of pages12
JournalOphthalmology Retina
Volume4
Issue number10
Early online date25 Apr 2020
DOIs
Publication statusPublished - Oct 2020
Externally publishedYes

Bibliographical note

Funding Information:
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Obtained funding: N/A

Publisher Copyright:
© 2020 American Academy of Ophthalmology

Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.

ASJC Scopus subject areas

  • Ophthalmology

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