Stem cell trial aims to cure AMD

London-The London Project to Cure Blindness announced it successfully performed a surgery to transplant retinal pigment epithelium (RPE) derived from stem cells into a patient suffering from vision loss from wet age-related macular degeneration (AMD).

The surgery was the first in a trial to investigate the safety and efficacy of transplanting the cells using a specifically engineered patch inserted behind the retina. The surgery takes one to two hours.

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According to the London Project to Cure Blindness, the operation took place last month, and there have been no complications reported. The organization says it hopes to report the patient’s outcome in terms of initial visual recovery by early December 2015.

Researches plan to recruit 10 patients over an 18-month period. The patients will be followed over the course of 12 months to assess the safety and stability of the cells and their effect in restoring vision.

“There is real potential that people with wet age-related macular degeneration will benefit in the future from transplantation of these cells,” says retinal surgeon Lyndon Da Cruz, MA, MBBS, PhD, FRCOphth, FRACO, from Moorfields Eye Hospital, who is performing the operations and is co-leading the London Project.

Next: The future of AMD treatment?

The future of AMD treatment?

Will the London Project’s stem cell treatment be the answer to this devastating disease? Several experts say these kinds of advances are encouraging, but safety and efficacy will need to be proven.

“The reality is that I think it is too early to tell which of the stem cell projects will be the most viable,” says Optometry Times Editorial Advisory Board member Jeffry Gerson, OD, FAAO. “I do think that there will ultimately be a treatment for AMD using stem cells. A unique feature of the London Project is the collaboration of multiple groups, and I think that this type of cooperation will only help the cause.”

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Other experts agree that more information is needed.

“Stem cell therapy is exciting for a number of ophthalmic problems from limbal stem-cell deficiency and ganglion-cell rescue and regeneration in glaucoma,” says Optometry Times Editorial Advisory Board member Leo Semes, OD, FAAO. “There a number of hurdles which it appears that these investigators have begun to solve-getting a cellular component that works, applying it safely to the target area. Right now, there has been this one human patient on whom this has been tried.”

Dr. Semes says RPE patches harvested from a patient’s periphery was tried about a decade ago, but the efficacy endpoints were not met.

“And, every silver lining has a cloud-the potential for tumorogenesis from the transplant/implant of this tissue,” he says. “In the end, if this works, it represents an alternative to the current anti-VEGF therapy.”

Dr. Semes says there should be more development of preventative strategies to halt the progression to wet AMD.

Next: The importance of staying up on research

The importance of staying up on research

“This study, as well as others, has seemed to indicate that the actual process of RPE stem cell transplantation appears possible, and safe,” says Optometry Times Editorial Advisory Board member Steven Ferrucci, OD, FAAO. “What we still do not know is the potential visual improvement.”

Dr. Ferrucci says that regardless of the outcome of this particular trial, it’s important that ODs stay up to date on the latest vision research.

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“We should be knowledgeable so we can provide the information to the patient, without overpromising its effects,” he says. “Also, we should try to be aware of studies in our area that may be of interest to patients and that perhaps patients could enroll in.”

But Dr. Ferrucci says, there are a limited number of research centers doing such studies, and getting patients enrolled in such studies is very difficult because the inclusion/exclusion criteria is limiting.

“So, while this and similar studies and reports are encouraging, they must be tempered with the fact that it may still be years until we know if this is a true treatment for our patients’ suffering from AMD, and perhaps even longer until it is readily available,” he says. “While this may hopefully help patients in the future, I am afraid it may not be able to help a patient in our chair today with new wet AMD and subsequent vision loss.”

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