Autologous Neurosensory Retinal Flap Transplantation in a Porcine Model of Retinal Hole

IF 3.2 Q1 OPHTHALMOLOGY
Madeline E. Olufsen MD , Jens Hannibal MD , Nina B. Soerensen MD , Anders T. Christiansen MD , Ulrik C. Christensen MD , Grazia Pertile MD , David H. Steel MD , Steffen Heegaard MD , Jens F. Kiilgaard MD
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引用次数: 0

Abstract

Purpose

Autologous retinal transplantation has been successfully employed in the treatment of large and myopic macular holes that are refractory to standard surgical treatments. Patients transplanted with a peripheral neurosensory retinal graft have shown unexpected improvements in visual acuity. The study aims to investigate if neural integration of the graft takes place in a porcine model of retinal hole.

Design

Experimental animal study.

Subjects

Left eyes of 10 Danish landrace pigs.

Methods

The pigs underwent vitrectomy under general anesthesia, and a subretinal bleb was created within the visual streak on both sites of the optic disc. A retinal hole, approximately 1900 to 4000 microns in size, was cut temporally using a vitrector. A graft of matching size was harvested from the nasal retina. The graft was gently moved toward the retinal hole under perfluoro-n-octane and placed within it. Endolaser was applied around the donor site, and either air or oil tamponade was used. OCT and color fundus photography were performed 2 and 6 weeks after surgery. At the end of follow-up, the eyes were enucleated for histological examination, including immunohistochemical analysis with antibodies against retinal glial cells, photoreceptors, and inner retinal neurons.

Main Outcome Measures

The primary outcome measures were the morphology of the graft and the junctional area between the host and the graft.

Results

Retinal hole closure was achieved in 9 of 10 cases, with the graft remaining in situ in 6 cases. In 4 cases, OCT scans indicated preservation of the outer retinal layers, and in 2 of these cases, there was apparent integration with the adjacent host retina. Corresponding histology confirmed the preservation of the photoreceptor layer in 3 cases, but there was no evidence of graft integration with degeneration of the inner retina in all cases. The distance between the margins of the retinal hole decreased during follow-up, suggesting that the graft contracts and drags the surrounding retina toward the center.

Conclusions

The outer retina of a retinal graft can be preserved, while the inner retina degenerates. No evidence of neuroretinal integration of the graft was observed. The retinal graft serves as a scaffold, promoting the centripetal migration of the edges of the hole, resulting in closure of large retinal holes.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
自体神经感觉视网膜瓣移植在猪视网膜孔模型中的应用。
目的:自体视网膜移植成功地治疗了标准手术治疗难治性大、近视黄斑孔。患者移植与周围神经感觉视网膜移植物显示出意想不到的改善视力。本研究旨在探讨移植物是否在猪视网膜孔模型中发生神经整合。设计:实验动物研究。实验对象:10只丹麦长白猪的左眼。方法:猪在全身麻醉下行玻璃体切除术,在视盘两侧的视条纹内形成视网膜下泡。一个视网膜洞,大约1900到4000微米的大小,暂时用一个玻璃体切割。从鼻视网膜上取下大小匹配的移植物。在全氟辛烷下将移植物轻轻地移向视网膜孔并置于其中。在供体周围应用激光,并使用空气或油填塞。术后2周和6周分别行OCT和眼底彩色摄影。在随访结束时,摘除眼球进行组织学检查,包括免疫组织化学分析针对视网膜胶质细胞、光感受器和视网膜内神经元的抗体。主要观察指标:主要观察指标为移植物的形态和宿主与移植物之间的连接面积。结果:10例患者中9例视网膜孔洞闭合,6例植皮保持原位。4例OCT扫描显示视网膜外层保留,其中2例与邻近宿主视网膜明显融合。相应的组织学证实3例有感光层保存,但未见移植物融合并内视网膜变性的证据。随访期间,视网膜孔边缘之间的距离减小,提示移植物收缩并将周围视网膜拖向中心。结论:视网膜移植术后外视网膜可保留,内视网膜可发生变性。未观察到移植物神经视网膜整合的证据。视网膜移植物作为支架,促进孔边缘向心迁移,导致大的视网膜孔闭合。财务披露:专有或商业披露可在本文末尾的脚注和披露中找到。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ophthalmology science
Ophthalmology science Ophthalmology
CiteScore
3.40
自引率
0.00%
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0
审稿时长
89 days
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