Abstract
Retinal degenerations cause permanent visual loss and affect millions world-wide. Current treatment strategies, such as gene therapy and anti-angiogenic drugs, merely delay disease progression. Research is underway which aims to regenerate the diseased retina by transplanting a variety of cell types, including embryonic stem cells, fetal cells, progenitor cells and induced pluripotent stem cells. Initial retinal transplantation studies injected stem and progenitor cells into the vitreous or subretinal space with the hope that these donor cells would migrate to the site of retinal degeneration, integrate within the host retina and restore functional vision. Despite promising outcomes, these studies showed that the bolus injection technique gave rise to poorly localized tissue grafts. Subsequently, retinal tissue engineers have drawn upon the success of bone, cartilage and vasculature tissue engineering by employing a polymeric tissue engineering approach. This review will describe the evolution of retinal tissue engineering to date, with particular emphasis on the types of polymers that have routinely been used in recent investigations. Further, this review will show that the field of retinal tissue engineering will require new types of materials and fabrication techniques that optimize the survival, differentiation and delivery of retinal transplant cells.
Highlights
Degenerative retinal diseases are a large group of conditions that if left untreated can result in irreversible blindness
Today there are a variety of treatment options for individuals with wet age related macular degeneration (AMD), including the intraocular injection of anti-vascular endothelial growth factor (VEGF) drugs and photodynamic therapy
This study showed for the first time that the transplanted human embryonic stem cells (ESCs) derived RPE mimicked gene expression in vivo as evidenced by the down regulation of the immature eye field marker Pax6 with the concurrent up regulation of mature
Summary
Degenerative retinal diseases are a large group of conditions that if left untreated can result in irreversible blindness. Treatment options for individuals with atrophic retinal diseases, like dry AMD and RP, have been limited to dietary supplements and some preliminary drug trials, which are designed to delay disease progression [4]. It is believed that the inner retina’s viability is a product of its dual blood supply, in which the outer retina is nourished by the fenestrated choriocapillaris and the inner retina is satiated by the retinal circulatory system [9,10] This unique disease pathology provides a foothold for a variety of therapeutic options, including cell based therapies
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