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Effects of mesenchymal stem cells and their exosomes on the healing of large and refractory macular holes

Graefe's Archive for Clinical and Experimental Ophthalmology volume 256, pages 2041–2052 (2018)Cite this article

Abstract

Purpose

To assess the efficacy of mesenchymal stem cells (MSCs) and MSC-derived exosomes (MSC-Exos) to promote the healing of large and refractory macular holes (MHs).

Methods

Seven patients (age 51–75 years old) with large and long-standing idiopathic MHs underwent vitrectomy, internal limiting membrane peeling, MSC (two patients) or MSC-Exo (five patients) intravitreal injection, and heavy silicon oil, air, 20% SF6, or 14% C3F8 tamponade. The MSCs were isolated from human umbilical cord tissue, and MSC-Exos were isolated from the supernatants of cultured MSCs using sequential ultracentrifugation.

Results

Five eyes underwent pars plana vitrectomy (PPV) only, while two underwent PPV combined with cataract surgery. Six MHs were closed, while one remained in a flat-open state. The best-corrected visual acuity (BCVA) was improved in five patients with MH closure and remained unchanged in one patient with MH closure who had a 4-year history of MH. A fibrotic membrane was observed on the surface of the retina in one patient who underwent MSC therapy. One patient who received a higher dose of MSC-Exos exhibited an inflammatory reaction.

Conclusions

MSC and MSC-Exo therapy may promote functional and anatomic recovery from MH. MSC-Exo therapy may be a useful and safe method for improving the visual outcomes after surgery for refractory MHs.

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Funding

This research was supported by grants from the National Natural Science Foundation of China (81371005) and the Tianjin Municipal Science and Technology Commission (15JCZDJC35600).

Author information

Author notes

  1. Xiaomin Zhang and Juping Liu contributed equally to this report and are co-first authors.

Affiliations

  1. Department of Uveitis & Ocular Immunology, Tianjin Medical University Eye Hospital, Eye Institute & School of Optometry and Ophthalmology, Tianjin, China

    Xiaomin Zhang

  2. Laboratory of Stem Cells, Tianjin Medical University Eye Hospital, Eye Institute & School of Optometry and Ophthalmology, Tianjin, China

    Xiaomin Zhang & Feifei Ma

  3. Department of Vitreous and Retina, Tianjin Medical University Eye Hospital, Eye Institute & School of Optometry and Ophthalmology, Tianjin, China

    Juping Liu, Bo Yu, Xinjun Ren & Xiaorong Li

Authors
  1. Xiaomin Zhang
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  2. Juping Liu
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  3. Bo Yu
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  4. Feifei Ma
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  5. Xinjun Ren
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  6. Xiaorong Li
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Corresponding author

Correspondence to Xiaorong Li.

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The authors declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Research involving human participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Zhang, X., Liu, J., Yu, B. et al. Effects of mesenchymal stem cells and their exosomes on the healing of large and refractory macular holes. Graefes Arch Clin Exp Ophthalmol 256, 2041–2052 (2018). https://doi.org/10.1007/s00417-018-4097-3

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  • DOI: https://doi.org/10.1007/s00417-018-4097-3

Keywords

  • Exosomes
  • Macular hole
  • Mesenchymal stem cells
  • Pars plana vitrectomy