幹細胞治療在乾性老年性黃斑部退化的應用

10.6666/ClinMed.201810_82(4).0109

林泰祺

老年性黃斑部退化 ； 幹細胞治療 ； 視網膜色素上皮細胞

臨床醫學月刊

82卷4期（2018 / 10 / 26）

597 - 600

繁體中文

許多視網膜退化的病變如：視網膜色素變性(retinitis pigmentosa)、老年性黃斑部退化以及斯特格氏症(Stargardt disease)等，都會導致感光細胞以及視網膜色素上皮細胞的缺失進而影響視力。因此，以幹細胞分化而成的視網膜色素上皮細胞來取代有缺失的細胞，不失為一種可行的治療方式。其中臺北榮總團隊的石牌地區研究發現，年紀大於65歲以上的老年人，罹患老年性黃斑部退化的比例高達11.1%。目前對於濕性老年性黃斑部退化，已有許多治療方式，包括傳統的雷射光凝固治療、光動力雷射治療以及玻璃體內抑制血管內皮生成因子藥物注射。但是對於乾性老年性黃斑部退化，至今仍沒有有效的治療方式。因此，比起上述其他盛行率相對較低的視網膜退化疾病，乾性老年性黃斑部退化更需要積極研究幹細胞治療策略在臨床上的可行性。本文將探討目前幹細胞治療在乾性老年性黃斑部退化的應用。

1. Benner, JD,Sunness, JS,Ziegler, MD(2002).Limited macular translocation for atrophic maculopathy.Arch Ophthalmol,120,586-591.
2. Binder, S,Stolba, U,Krebs, I(2002).Transplantation of autologous retinal pigment epithelium in eyes with foveal neovascularization resulting from agerelated macular degeneration: A pilot study.Am J Ophthalmol,133,215-225.
3. Cahill, MT,Freedman, SF,Toth, CA(2003).Macular translocation with 360 degrees peripheral retinectomy for geographic atrophy.Arch Ophthalmol,121,132-133.
4. Caramoy, A,Liakopoulos, S,Menrath, E(2010).Autologous translocation of choroid and retinal pigment epitheliumin geographic atrophy: long-term functional and anatomical outcome.Br J Ophthalmol,94,1040-1044.
5. Carr, AJ,Vugler, AA,Hikita, ST(2009).Protective effects of human iPSderived retinal pigment epithelium cell transplantation in the retinal dystrophic rat.PLoS One,4,e8152.
6. da, Cruz, L,Chen, FK,Ahmado, A(2007).RPE transplantation and its role in retinal disease.Prog Retin Eye Res,26,598-635.
7. Ferris, FL,Wilkinson, CP,Bird, A(2013).Clinical classifi cation of age-related macular degeneration.Ophthalmology,120,844-851.
8. Gouras, P,Algvere, P(1996).Retinal cell transplantation in the macula: new techniques.Vision Res,36,4121-4125.
9. Gouras, P,Flood, MT,Kjedbye, H(1985).Transplantation of cultured human retinal epithelium to Bruch´s membrane of owl monkey´s eye.Curr Eye Res,4,253-265.
10. Gouras, P,Lopez, R,Kjeldbye, H(1989).Transplantation of retinal epithelium prevents photoreceptor degeneration in the RCS rat.Prog Clin Biol Res,314,659-671.
11. Heussen, FM,Fawzy, NF,Joeres, S(2008).Autologous translocation of the choroid and RPE in age-related macular degeneration: 1-year follow-up in 30 patients and recommendations for patient selection.Eye,22,799-807.
12. Joussen, AM,Joeres, S,Fawzy, N(2007).Autologous translocation of the choroid and retinal pigment epitheliumin patients with geographic atrophy.Ophthalmology,114,551-560.
13. Kamao, H,Mandai, M,Wakamiya, S(2014).Objective evaluation of the degree of pigmentation in human induced pluripotent stem cell-derived RPE.Invest Ophthalmol Vis Sci,55,8309-8318.
14. Klein, R,Meuer, SM,Knudtson, MD(2008).The epidemiology of progression of pure geographic atrophy: the Beaver Dam Eye Study.Am J Ophthalmol,146,692-699.
15. Li, LX,Turner, JE(1988).Inherited retinal dystrophy in the RCS rat:prevention of photoreceptor degeneration by pigment epithelial cell transplantation.Exp Eye Res,47,911-917.
16. Lu, B,Zhu, D,Hinton, D,Humayun, MS(2012).Mesh-supported submicron parylene-C membranes for culturing retinal pigment epithelial cells.Biomed Microdevices,14,659-667.
17. Miller, JW(2013).Age-relatedmacular degeneration revisited piecing the puzzle: the LXIX Edward Jackson memorial lecture.Am J Ophthalmol,155,1-35e13.
18. Schwartz, SD,Regillo, CD,Lam, BL(2015).Human embryonic stem cell-derived retinal pigment epithelium in patients with age-related macular degeneration and Stargardt´s macular dystrophy: follow-up of two open-label phase 1/2 studies.Lancet,385,509-516.
19. Schwartz, SD,Tan, G,Hosseini, H(2016).Subretinal transplantation of embryonic stem cell-derived retinal pigment epithelium for the treatment of macular degeneration: An assessment at 4 years.Invest Ophthalmol Vis Sci,57,ORSFc1-ORSFc9.