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Complication of Autologous Stem Cell Transplantation in Retinitis Pigmentosa

Katherine Boudreault, MD, FRCS1,2,3; Sally Justus, BA1,2; Winston Lee, MSc1,2; Vinit B. Mahajan, MD, PhD4; Stephen H. Tsang, MD, PhD1,2
[+] Author Affiliations
1Barbara and Donald Jonas Laboratory of Regenerative Medicine, Columbia University, New York, New York
2Bernard and Shirlee Brown Glaucoma Laboratory, Department of Ophthalmology, Columbia University, New York, New York
3Department of Ophthalmology, University of Montreal, Montreal, Quebec, Canada
4Omics Laboratory, Department of Ophthalmology and Visual Science, University of Iowa, Iowa City
JAMA Ophthalmol. 2016;134(6):711-712. doi:10.1001/jamaophthalmol.2016.0803.
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This case report describes a patient with central retinal artery occlusion following autologous bone marrow peribulbar stem cell injection for retinitis pigmentosa.

Advances in stem cell–mediated regenerative medicine have had a profound effect on interventional approaches to irreversible, blinding retinal diseases. In 2015,1 transplant of retinal pigment epithelial cells derived from human embryonic stem cells was shown to be safe in a phase 1/2 clinical trial for patients with age-related macular degeneration and Stargardt disease. Research involving induced pluripotent stem cells for retinal degenerative diseases also shows promise.2 Despite the potential of this therapeutic practice, many unregulated stem-cell treatments have emerged3 that may be harmful. We present a case of central retinal artery occlusion following autologous bone marrow peribulbar stem cell injection for retinitis pigmentosa.

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Figure.
Central Retinal Artery Occlusion in the Left Eye Following Peribulbar Stem Cell Injection in a Patient With Retinitis Pigmentosa

Before surgery: unremarkable color picture (A) in the right eye. Autofluorescence imaging in the left eye (B) reveals abnormal retina peripherally, with corresponding photoreceptor loss on optical coherence tomography (C). After surgery: central retinal artery occlusion in the left eye (D); faint retinal vessels on autofluorescence imaging (E); and thinning of all retinal layers on optical coherence tomography (F).

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