Aged Retinal Pigment Epithelium Research Articles

Migration and proliferation of retinal pigment epithelium on extracellular matrix ligands

We compared aged adult and fetal retinal pigment epithelium (RPE) migration and proliferation in cell culture. Aged adult RPE resurfaced on dishes coated with human or mouse laminin, human or rat collagen I, human or mouse collagen IV, or human fibronectin. Resurfacing was best on bovine corneal endothelial cell extracellular matrix. Resurfacing was worst on mouse laminin. Fetal RPE resurfacing was robust on all surfaces studied except human and mouse laminin. In general, fetal RPE resurfacing was much greater than that seen with aged RPE on comparable surfaces. The degree of cell proliferation (labeled by Ki-67) was much greater in fetal than adult RPE cells.

Age-related macular degeneration and retinal pigment epithelium wound healing.

Choroidal new vessel (CNV) excision may improve vision in patients with age-related macular degeneration (AMD) by eliminating the source of subretinal bleeding and scarring. Visual recovery after CNV excision is usually poor in AMD patients, probably because of removal of the associated retinal pigment epithelium (RPE), coupled with the inability of native RPE at the edge of the dissection bed to resurface the iatrogenic RPE defect. Experiments using in vitro and in vivo RPE wound-healing models have provided insight into the factors that regulate RPE wound healing in situ.Wound-healing studies using aged submacular human Bruch's membrane in organ culture show that resurfacing of localized RPE defects is influenced by the depth of damage to Bruch's membrane as well as factors that are intrinsic to the aged RPE at the wound edge. The Bruch's membrane organ-culture paradigm provides a surface for RPE wound healing that closely resembles the surface on which RPE must grow after CNV excision in AMD patients. An understanding of the factors that influence RPE wound healing might lead to treatments that stimulate RPE resurfacing and improve visual outcome after CNV excision.

Subretinal Fibrosis After Laser Photocoagulation for Diabetic Macular Edema

Seven eyes had subretinal fibrosis after grid laser photocoagulation for diabetic macular edema. The fibrosis caused persistent loss in visual acuity, and in six of the seven eyes, was not associated with detectable laser-induced Bruch's membrane rupture or subretinal hemorrhage. Choroidal neovascularization was detected in only one patient, who was notably younger (27 years) than the median age of 70 years in this series. The median preoperative visual acuity was 20/80 (range, 20/40 to 20/400); the median postoperative visual acuity was 20/400 (range, 20/80 to counting fingers). The subretinal fibrosis was detected at a median of three months (range, 14 days to 4 1/2 months) after laser therapy. In one of five bilaterally treated patients (20%), subretinal fibrosis developed in both eyes. Subretinal fibrosis may be caused by undetected choroidal neovascularization or by excessive proliferation after stimulation of an aged retinal pigment epithelium. Subretinal fibrosis may be a potential cause of loss in visual acuity after laser treatment for diabetic macular edema.