Safety of autologous bone marrow mesenchymal stem cells transplantation in proliferative diabetic retinopathy patients

Abstract

Objective To investigate the safety of autologous bone marrow mesenchymal stem cells (ABMSCs) transplantation into the subretinal space for the treatment of proliferative diabetic retinopathy (PDR). Methods The clinical data of four PDR patients (four eyes) who received ABMSCs transplantation into the subretinal space were collected in Army Medical University, Southwest Eye Hospital from March 2014 to December 2015, including 3 males and 1 female; the average age was 55 years old; the average course of diabetes was 10 years, and the blood glucoses were all well controlled before treatment.All the patients underwent conventional ophthalmologic examination, and visual acuity, slit lamp microscope, color fundus photography, fluorescein angiography (FFA) and optical coherence tomography (OCT) examination were performed at 1 week, 1 month, 3 months, 6 months, 9 months and 12 months after surgery.This study protocol was approved by Ethic Committee of Army Medical University, Southwest Eye Hospital (No.2013-34). Results Four patients diagnosed as PDR were enrolled in this study.All patients were performed ABMSC transplantation, and no one felt discomfort after treatment.FFA and OCT showed that the transplanted cells were present in the subretinal space until 1 month after transplantation.The macular edema of one patient diagnosed as macular edema preoperatively was relived gradually after transplantation, and the effects lasted 3 months after transplantation.The preoperative best corrected visual acuity (BCVA) of the two patients were improved from hand movement and finger counting to 20/20 (84 ETDRS) and 20/200 (38 ETDRS) after transplantation, respectively, and the visual acuities of the other two eyes were both stable.All patients underwent panretinal photocoagulatio 3 months after transplantation, and the follow-up treatment complied with the routine of post-vitrectomy for DR, no complications occurred during the follow-up period. Conclusions Subretinal transplantation of ABMSCs for PDR is safe.The transplanted cells show local anti-inflammatory effect, and no effect on cell proliferation or circulatory improvement are observed. Key words: Diabetic retinopathy; Autologous bone marrow mesenchymal stem cell; Subretinal transplantation