Can cell-based therapy in patients with optic atrophy be considered a biological visual rehabilitation?

Purpose : Optic atrophy (OA) is usually the end-stage of many diseases of the optic nerve. Up-to-date optical magnification devices are the only option to improve visual abilities in patients with OA. Recent studies have reported that growth factors (GF), directly or in cell-mediated mode, can be responsible for neuroenhancement effects. Among different techniques, Limoli Retinal Restoration Technique (LRRT), builds a suprachoroidal autograft of adipocytes, adipose-derived stem cells and platelets, able to produce directly into the choroidal space GF and, consequently, retinal neuroenhancement. We performed a retrospective, observational clinical study to explore changes in the visual function of patients with OA treated with LRRT. Methods : Inclusion criteria was stabilized OA. Exclusion criteria the coexistence of other eye diseases like high myopia, retinitis pigmentosa, cataract, macular degeneration, or very disabling brain disorders. 33 eyes of 20 low vision patients (15 males and 5 females), mean age of 43.12 years (range 16-84), were recruited. The eyes were divided into two groups: A as a control (16 eyes), B treated with LRRT (17 eyes). Each patient performed a base-line and 6 months follow-up, complete eye examination including BCVA (logMAR), near visus (pt), threshold sensitivity (TS) by Maia microperimetry (dB) and fundus examination. The tenets of the Declaration of Helsinki were observed. Results : After 6 months, the mean BCVA in group A changed from 0.720 to 0.698 logMAR (+3.10% - P> 0.5), while group B from 0.638 to 0.632 logMAR (+0.95% - P> 0.5). Mean near visus in group A changed from 25,38 to 25 pts (+1.50% - P> 0.5), while in B from 25,53 to 18,76 pts (+25.52% - P> 0.5). Mean TS in group A changed from 6.27 to 6.59 dB (+6.16% - P> 0.5) while in B from 7.37 to 9,09 dB (+23.34% - P> 0.5). In all eyes near visus was achieved with mean magnification of 3X. Conclusions : This study shows that the LRRT may improve visual performance in visually impaired patients. Further studies are encourage to determine if biological rehabilitation is possible with cell-based therapy as retinal neuroenhancement.