Células Tronco de Medula Óssea no tratamento da Degeneração Macular

Abstract: Background: Dry age-related macular degeneration (AMD) is one of the leading causes of
vision loss in older patients. The macula accumulates drusen with loss of retinal pigment epithelial
cells and photoreceptors. Abnormal subretinal neovascularization is absent. There is no effective
drug therapy for dry AMD and a large proportion of patients progress to legal blindness from macular
atrophy. The Stem Cell Ophthalmology Treatment Study (SCOTS) was conducted to assess the effect
of bone marrow-derived stem cells (BMSCs) on dry AMD and other retinal and optic nerve diseases.
Methods: Thirty-two eyes were treated with BMSC per the protocols in SCOTS. Provision of BMSCs
in Arm 1 was via retrobulbar (RB), sub-tenons (ST) and intravenous (IV); Arm 2 via intravitreal, RB,
ST and IV; Arm 3 via subretinal and IV. Patient age averaged 78 years old and ranged from 69 to 90.
Visual acuity preoperatively ranged from counting fingers to 20/50-2 with an average preoperative
LogMAR of 1.125. Results: Following treatment, 20 of 32 (63%) of eyes experienced improvement in
visual acuity averaging 27.6% on LogMAR and ranging from 2.5% to 44.6%. The mean improvement
in LogMAR was 0.963 with a standard deviation (SD) of 0.42. The visual acuity remained stable in
34% of treated eyes. One eye continued to worsen as a consequence of disease progression. The
results showed high statistical significance with p ≤ 0.001. The procedures were conducted safely,
and no complications were observed. Conclusions: Treatment of dry AMD with BMSC using the
protocols developed in the SCOTS clinical trial has shown statistically significant clinical benefit
improving visual acuity and potentially delaying visual loss in the disease.