New horizons in ophthalmology: stem cell therapy
Becoming popular in many fields of medicine, stem cell therapies are used in treatment of certain eye diseases as well. Such therapies that give hope to selected patients are performed after the approval of Stem Cell Council affiliated to the Ministry of Health is obtained.
Do not ignore regular eye exams…
It would not be wrong to speculate that eyesight is one of our most important senses that affect the quality of life. In fact, the negative impacts of vision loss on the quality of life are much more notable even than that of cancers. Despite this, these organs are rather ignored by people until they face a problem. Stating that visual impairment is the most common reason to seek eye care, Professor of Opthalmology Ayşe Öner from Acıbadem Kayseri Hospital says ”Most of visual impairments can be corrected with eyeglasses. Visual impairments, secondary to age-related cataract, can be treated with surgery. However, other treatment modalities are need to treat more severe vision losses caused by retinal disorders.”
Stem cell can regenerate itself
Some of retinal disorders can be managed through intraocular injections which became popular nowadays.Bleeding and edema, secondary to diabetes, retinal artery occlusion and wet type macular degeneration, are the most common ones. Emphasizing that stem cell therapy has been, recently, put on the agenda for treatment of inherited retinal disorders which develop at younger ages and result in progressive visual impairments, Prof. Öner states that it is, first, necessary to make a clear definition of stem cell in this issue:“Simply, the precursor cells -the purest form of cell and the most basic cell in the human body – are capable of transforming into other cells. Stem cells can spontaneously settle into an appropriate growth environment, proliferate, differentiate into other cell types and generate relevant cell types. They can also regenerate themselves and ensure sustainability of their own group of cells. They have the potential to repair and restore functions of tissues after an injury in any part of the body. They substitute for damaged retinal cells and repair them because of these potentials. Stem cells are used and considered a treatment option for many diseases owing to their properties.”
Early diagnosis increases success of treatment
Use of this treatment modality is based on fulfilling a set of criteria… First, integrity of the eye should have been protected for stem cell therapy. Stem cell does not help patients with deformed eyes or reduced size of the eye. The second important matter is the visual accuracy. Stem cell therapy is not useful for totally blind patients. Therefore, optimal group of patients include the people without an advanced level of visual impairment.
The primary goal of the stem cell therapy is to stop progression of the disease. Visual acuity is improved and the visual field is enlarged in 60 to 80 percent of the patients. The higher preoperative visual acuity, the better improvement in the postoperative acuity. Moreover, stating that enlarged visual field and improvement of retinal functions are also noted, Professor Öner says “The earlier treatment is started, the better outcomes are obtained. Therefore, early diagnosis and treatment is very crucial”.
Mesenchymal stem cell is used
Certain examinations are required for patients who are good candidates of the stem cell therapy. Visual field, Optic Coherence Tomography and electrophysiology tests are reviewed to determine whether the patient is eligible for stem cell therapy. For optimal patients, the Stem Cell Council of the Ministry of Health is applied for approval before the therapy. Stating that the surgery is planned after an approval is obtained, Professor Öner informs about details of the treatment: “In our clinic, umbilical cord-derived mesenchymal stem cells are used.“We prefer suprachoroidal or extra-ocular procedures, because this approach is safer and it does not contraindicate the subsequent treatments. The surgical procedure can be performed under general or local anesthesia depending on the preference of the patient. We also carry out the surgery for one eye or both eyes in the same session again depending on the preference of the patient. Eye drop treatment is maintained for one month in the postoperative course. The patient is evaluated one day after the surgical procedure and followed up in Month 1, Month 3 and Month 6. Next, visual field and OCT tests are repeated in semi-annual follow-up visits.”
It may be used in treatment of numerous eye diseases
Stem cell therapies are mostly used for inherited diseases of retina, optic nerve and cornea. The retinal diseases that meet criteria of indication include retinitis pigmentosa, also called night blindness, Stargardt macular dystrophy, age-related macular degeneration – especially the dry type that is also called yellow spot disease – and other degenerative retinal disorders. The optic nerve diseases include optic atrophies secondary to glaucoma, trauma or other etiologies as well as idiopathic cases.
