Macular Degeneration Stem Cell Therapy

08 February 2020 Written by
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Macular Degeneration Stem cell Therapy researchers are making great progress in their efforts to replace the RPE layer, which they believe will halt or even reverse the vision loss associated with Age-related Macular Degeneration (AMD).

A new stem cell transplant in Macular Degeneration Stem Cell Therapy might help preserve or even restore vision being lost to the dry form of age-related macular degeneration, a new pilot clinical trial has shown.

An overview

Age-related macular degeneration is one of the most common causes of vision loss in developed countries, affecting between 30 million and 50 million people worldwide.

As the name suggests, age-related macular degeneration (AMD) is most common in people over 60, and more people are suffering from AMD as the population ages. About 90 percent of AMD cases are dry AMD, for which there is no good treatment today.

Dry age-related macular degeneration (AMD) is a complex condition that distorts a patient’s vision. Left untreated, the disease can develop into wet AMD, which is more severe. Wet AMD causes retinal leaking and bleeding, vision changes, and eye damage that cannot be reversed.

What Is Macular Degeneration?

Macular degeneration is a progressive health condition in which the patient’s vision becomes more and more blurry or distorted over time. If left unchecked, AMD can result in significant loss of sight, or even blindness in many patients. This will in turn affect the individual’s ability to engage in everyday activities such as driving a car, reading a book or magazine, or even handling basic chores, such as washing dishes or vacuuming the house.

In AMD, the RPE cells stop performing their support functions and the rods and cones die, resulting in a loss of central vision. Dry AMD typically progresses over several years. In the less common wet AMD, something (scientists aren’t sure what) spurs abnormal blood vessel growth, and central vision can be lost in a matter of weeks or days.

What Causes Macular Degeneration?

Macular degeneration is caused by a thinning of the macula, which is the part of the retina “responsible for clear vision in your direct line of sight”. However, there are two underlying causes here, and each leads to a different type of macular degeneration.

Dry and Wet Macular Degeneration

Dry macular degeneration is generally caused by yellowish deposits of drusen building up on the macula. This issue generally affects the vision of people while they read and is the most common type of AMD. Wet macular degeneration, on the other hand, is caused by the development of abnormal blood vessels under the macular tissue, which leak fluid into the retina. The abnormal tissue growth and fluid leakage lead to the development of scar tissue, and permanent loss of vision.

While both types of macular degeneration occur as we age, the underlying cause of the condition is not well known. It is suspected that there is a hereditary component, but there are other factors as well, including lifestyle choices like smoking, as well as health factors, such as obesity and hypertension, that can make a person more likely to develop AMD. In addition, macular degeneration is more common in Caucasian females with light-colored eyes than in any other demographic.

What Are the Symptoms of Macular Degeneration?

In many cases, there are no discernible symptoms of macular degeneration in the early stages, which can last for many years. Generally, patients do not notice anything out of the ordinary until the condition affects both eyes and has worsened. Then, symptoms generally include blurred vision in one or both eyes, with a blurry spot in the center of the person’s range of vision. Changed perceptions of color, or a diminishing in the ability to perceive color can also be signs of macular degeneration.

Dry form symptoms are:

  • Need brighter light to read anything
  • Blurred printed or written texts
  • Colors appears less vibrant as they should be
  • Difficulty in recognizing the person’s face immediately
  • Vision is hazier and less defined

Wet form symptoms are:

  • Straight lines appear wavy or crooked
  • Loss of central vision
  • Central vision blind spot

Stem cell research for AMD

Stem cell research is helping scientists understand how the different cell types in the retina function together, which has led to exploring ways to replace both rods and cones and the supporting RPE cells.

Researchers are also exploring different methods to deliver stem cells to the eye, including creating patches of RPE cells in the lab. In one approach, a one-cell-thick layer of RPE cells derived from human embryonic stem cells or adult RPE stem cells is placed on a material that allows nutrients and waste materials to pass through and is implanted in the eye. In tests in animals, the patch has shown promise; the RPE cells appear to be stable and don’t migrate to other areas of the eye.

Stem cells for AMD

The concept is that stem cells are “undifferentiated,” meaning that they have the potential to develop into many different cell types, including retinal cells, which can then replace cells that have died due to AMD. The two major cell types that die in AMD are retinal pigment epithelial (RPE) cells and photoreceptors.

It is much easier to replace RPE cells than photoreceptors. RPE cells normally sit on a membrane in a single layer, where they support the photoreceptors. Without RPE cells, photoreceptors die. This is the sequence of events in at least some patients with the “geographic atrophy” form of advanced, dry AMD. Stem cells can be induced to become RPE cells relatively easily, and then injected into their proper location. The challenge is that often these cells form clumps rather than a single layer.

Stem cells are currently being explored as a potential treatment option for helping those suffering from both dry and wet macular degeneration. Stem cell therapy for macular degeneration is being explored in several different ways.

Conclusion

In summary, there is much excitement about the potential for stem cell transplantation in AMD, and this approach has a reasonable chance of helping patients with wet AMD or advanced dry (geographic atrophy) AMD at some point in the future. In the end, there are many options for treating macular degeneration, but only stem cell therapy shows the potential to halt and possibly reverse the damage done by the disease.

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