Surgical Method Advances Retinal Therapy Research for AMD
A new NIH surgical technique enables the sequential placement of two grafts in the retina.
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Scientists at the National Institutes of Health (NIH) have developed a surgical technique that allows for the sequential placement of two tissue grafts into the retina. Tested in animal models, the method could support comparative research into potential therapies for dry age-related macular degeneration (AMD), a condition that leads to vision loss in older adults. The results were published in JCI Insight.
A limitation in retinal therapy studies
Dry AMD involves the deterioration of retinal cells and the supporting tissue at the back of the eye. One area of research involves grafting lab-grown tissue derived from patient-specific stem cells to replace or support the damaged layers. However, traditional surgical methods have been limited to inserting a single graft per procedure. This restriction has hindered the ability to compare the effectiveness of different graft types within the same retinal environment.
To address this, NIH researchers designed a surgical clamp that stabilizes pressure in the eye and allows the insertion of two grafts in close succession. The clamp minimizes trauma to the surrounding tissue and makes it possible to study multiple treatments in the same retinal lesion.
Comparing graft effects in a single model
In their experiment, researchers induced AMD-like damage in animal models and inserted two types of grafts side-by-side. One graft was composed of retinal pigment epithelial (RPE) cells attached to a biodegradable scaffold. RPE cells are responsible for maintaining the health of photoreceptors, the light-sensitive cells required for vision. The other graft contained only the scaffold and served as a control.
Retinal pigment epithelial (RPE) cells
Specialized cells that form a supportive layer underneath the retina. They play a role in maintaining photoreceptor function and are often compromised in diseases such as AMD.
Photoreceptors
Cells in the retina that detect light and initiate the process of vision. Damage to these cells is a hallmark of AMD and other retinal diseases.
The RPE cells were developed from human blood cells reprogrammed into stem cells, a process that enables the creation of patient-specific tissue for transplantation.
After implantation, the researchers analyzed retinal images using artificial intelligence. The RPE cell-containing grafts helped preserve surrounding photoreceptors, whereas those near the scaffold-only grafts experienced a higher rate of degeneration. Moreover, the RPE grafts supported regeneration of the choriocapillaris, the network of blood vessels that provides the retina with essential nutrients and oxygen.
Choriocapillaris
A layer of small blood vessels located behind the retina. It provides oxygen and nutrients to both the RPE cells and photoreceptors, and its degeneration contributes to vision loss in AMD.
A platform for advancing AMD treatments
This dual-graft method offers a new approach for evaluating retinal therapies in vivo by enabling more precise comparisons within the same subject. While the findings are currently limited to animal models, they provide a foundation for further exploration of cell-based therapies for AMD.
Reference: Gupta R, Bunea I, Alvisio B, et al. iPSC-RPE patch restores photoreceptors and regenerates choriocapillaris in a pig retinal degeneration model. JCI Insight. 2025;10(10):e179246. doi: 10.1172/jci.insight.179246
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