Abstract
Human embryonic stem cells (hESCs)- and induced pluripotent stem cells (hiPSCs)-derived retinal organoids (ROs) are three-dimensional laminar structures that recapitulate the developmental trajectory of the human retina. The ROs provide a fascinating tool for basic science research, eye disease modeling, treatment development, and biobanking for tissue/cell replacement. Here we review the previous studies that paved the way for RO technology, the two most widely accepted, standardized protocols to generate ROs, and the utilization of ROs in medical discovery. This review is conducted from the perspective of basic science research, transplantation for regenerative medicine, disease modeling, and therapeutic development for drug screening and gene therapy. ROs have opened avenues for new technologies such as assembloids, coculture with other organoids, vasculature or immune cells, microfluidic devices (organ-on-chip), extracellular vesicles for drug delivery, biomaterial engineering, advanced imaging techniques, and artificial intelligence (AI). Nevertheless, some shortcomings of ROs currently limit their translation for medical applications and pose a challenge for future research. Despite these limitations, ROs are a powerful tool for functional studies and therapeutic strategies for retinal diseases.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Akerstrom B et al (2017) The role of mitochondria, oxidative stress, and the radical-binding protein A1M in cultured porcine retina. Curr Eye Res 42(6):948–961
Amirpour N et al (2012) Differentiation of human embryonic stem cell-derived retinal progenitors into retinal cells by sonic hedgehog and/or retinal pigmented epithelium and transplantation into the subretinal space of sodium iodate-injected rabbits. Stem Cells Dev 21(1):42–53
Arthur P et al (2022) Bioengineering human pluripotent stem cell-derived retinal organoids and optic vesicle-containing brain organoids for ocular diseases. Cell 11(21)
Banin E et al (2006) Retinal incorporation and differentiation of neural precursors derived from human embryonic stem cells. Stem Cells 24(2):246–257
Barber AC et al (2013) Repair of the degenerate retina by photoreceptor transplantation. Proc Natl Acad Sci U S A 110(1):354–359
Berber P et al (2021) Retinal organoid differentiation methods determine organoid cellular composition. J Transl Genet Genom
Bohrer LR et al (2019) Correction of NR2E3 associated enhanced S-cone syndrome patient-specific iPSCs using CRISPR-Cas9. Genes (Basel) 10(4)
Brown NL et al (1998) Math5 encodes a murine basic helix-loop-helix transcription factor expressed during early stages of retinal neurogenesis. Development 125(23):4821–4833
Cao UMN et al (2023) Microfluidic organ-on-a-chip: a guide to biomaterial choice and fabrication. Int J Mol Sci 24(4)
Chen M et al (2010) Generation of retinal ganglion-like cells from reprogrammed mouse fibroblasts. Invest Ophthalmol Vis Sci 51(11):5970–5978
Chen M et al (2019) Immune regulation in the aging retina. Prog Retin Eye Res 69:159–172
Chen M et al (2021) Human retinal progenitor cells derived small extracellular vesicles delay retinal degeneration: a paradigm for cell-free therapy. Front Pharmacol 12:748956
Cheng L et al (2022) Absence of Connexin 43 results in smaller retinas and arrested, depolarized retinal progenitor cells in human retinal organoids. Stem Cells 40(6):592–604
Chichagova V et al (2020) Human iPSC differentiation to retinal organoids in response to IGF1 and BMP4 activation is line- and method-dependent. Stem Cells 38(2):195–201
Chichagova V et al (2023) Incorporating microglia-like cells in human induced pluripotent stem cell-derived retinal organoids. J Cell Mol Med 27(3):435–445
Chirco KR et al (2021) Allele-specific gene editing to rescue dominant CRX-associated LCA7 phenotypes in a retinal organoid model. Stem Cell Rep 16(11):2690–2702
Cowan CS et al (2020) Cell types of the human retina and its organoids at single-cell resolution. Cell 182(6):1623–1640 e34
Cuevas E et al (2021) NRL(−/−) gene edited human embryonic stem cells generate rod-deficient retinal organoids enriched in S-cone-like photoreceptors. Stem Cells 39(4):414–428
Daniszewski M et al (2022) Retinal ganglion cell-specific genetic regulation in primary open-angle glaucoma. Cell Genomics 2(6):100142
Di Polo A et al (1998) Prolonged delivery of brain-derived neurotrophic factor by adenovirus-infected Muller cells temporarily rescues injured retinal ganglion cells. Proc Natl Acad Sci U S A 95(7):3978–3983
DiStefano TJ et al (2021) Accelerated and improved differentiation of retinal organoids from pluripotent stem cells in rotating-wall vessel bioreactors. Stem Cell Rep 16(1):224
Duan X et al (2007) Disrupted-in-schizophrenia 1 regulates integration of newly generated neurons in the adult brain. Cell 130(6):1146–1158
Eiraku M et al (2011) Self-organizing optic-cup morphogenesis in three-dimensional culture. Nature 472(7341):51–56
Eldred KC, Reh TA (2021) Human retinal model systems: strengths, weaknesses, and future directions. Dev Biol 480:114–122
Fernando M et al (2022) Differentiation of brain and retinal organoids from confluent cultures of pluripotent stem cells connected by nerve-like axonal projections of optic origin. Stem Cell Rep 17(6):1476–1492
Fligor CM et al (2021) Extension of retinofugal projections in an assembled model of human pluripotent stem cell-derived organoids. Stem Cell Rep 16(9):2228–2241
Fratta ID, Sigg EB, Maiorana K (1965) Teratogenic effects of thalidomide in rabbits, rats, hamsters, and mice. Toxicol Appl Pharmacol 7:268–286
Gabriel E et al (2021) Human brain organoids assemble functionally integrated bilateral optic vesicles. Cell Stem Cell 28(10):1740–1757 e8
Gagliardi G et al (2018) Characterization and transplantation of CD73-positive photoreceptors isolated from human iPSC-derived retinal organoids. Stem Cell Rep 11(3):665–680
Gao ML et al (2020) Patient-specific retinal organoids recapitulate disease features of late-onset retinitis pigmentosa. Front Cell Dev Biol 8:128
Gasparini SJ et al (2022) Transplanted human cones incorporate into the retina and function in a murine cone degeneration model. J Clin Invest 132(12)
Georgiou M et al (2020) Room temperature shipment does not affect the biological activity of pluripotent stem cell-derived retinal organoids. PloS One 15(6):e0233860
Hirose Y et al (2020) Hypnotic effect of thalidomide is independent of teratogenic ubiquitin/proteasome pathway. Proc Natl Acad Sci U S A 117(37):23106–23112
Hu ZL et al (2017) Neuroprotective effects of BDNF and GDNF in intravitreally transplanted mesenchymal stem cells after optic nerve crush in mice. Int J Ophthalmol 10(1):35–42
Huang KC et al (2019) Morphological and molecular defects in human three-dimensional retinal organoid model of X-linked juvenile retinoschisis. Stem Cell Rep 13(5):906–923
Hynes SR, Lavik EB (2010) A tissue-engineered approach towards retinal repair: scaffolds for cell transplantation to the subretinal space. Graefes Arch Clin Exp Ophthalmol 248(6):763–778
Isenmann S, Kretz A, Cellerino A (2003) Molecular determinants of retinal ganglion cell development, survival, and regeneration. Prog Retin Eye Res 22(4):483–543
Jagatha B et al (2009) In vitro differentiation of retinal ganglion-like cells from embryonic stem cell derived neural progenitors. Biochem Biophys Res Commun 380(2):230–235
Jahagirdar D et al (2022) Compartmentalized microfluidic device for in vitro co-culture of retinal cells. Biotechnol J 17(9):e2100530
Jomary C, Jones SE (2008) Induction of functional photoreceptor phenotype by exogenous Crx expression in mouse retinal stem cells. Invest Ophthalmol Vis Sci 49(1):429–437
Jomary C, Jones SE, Lotery AJ (2010) Generation of light-sensitive photoreceptor phenotypes by genetic modification of human adult ocular stem cells with Crx. Invest Ophthalmol Vis Sci 51(2):1181–1189
Kalargyrou AA et al (2022) Extracellular vesicles in the retina – putative roles in physiology and disease. Front Mol Neurosci 15:1042469
Kanber D et al (2022) RB1-negative retinal organoids display proliferation of cone photoreceptors and loss of retinal differentiation. Cancers (Basel) 14(9)
Kandoi S et al (2023) Disease modeling and pharmacological rescue of autosomal dominant Retinitis Pigmentosa associated with RHO copy number variation. medRxiv. 2023.02.27.23286248
Kashani AH et al (2021) One-year follow-up in a phase 1/2a clinical trial of an allogeneic RPE cell bioengineered implant for advanced dry age-related macular degeneration. Transl Vis Sci Technol 10(10):13
Kayama M et al (2010) Transfection with pax6 gene of mouse embryonic stem cells and subsequent cell cloning induced retinal neuron progenitors, including retinal ganglion cell-like cells, in vitro. Ophthalmic Res 43(2):79–91
Kim DK et al (2013) EVpedia: an integrated database of high-throughput data for systemic analyses of extracellular vesicles. J Extracell Vesicles:2
Kim S et al (2019) Generation, transcriptome profiling, and functional validation of cone-rich human retinal organoids. Proc Natl Acad Sci U S A 116(22):10824–10833
Kim J, Koo BK, Knoblich JA (2020) Human organoids: model systems for human biology and medicine. Nat Rev Mol Cell Biol 21(10):571–584
Kondo J, Inoue M (2019) Application of cancer organoid model for drug screening and personalized therapy. Cell 8(5)
Kruczek K et al (2017) Differentiation and transplantation of embryonic stem cell-derived cone photoreceptors into a mouse model of end-stage retinal degeneration. Stem Cell Rep 8(6):1659–1674
Kruczek K et al (2021) Gene therapy of dominant CRX-Leber congenital amaurosis using patient stem cell-derived retinal organoids. Stem Cell Rep 16(2):252–263
Kuwahara A et al (2015) Generation of a ciliary margin-like stem cell niche from self-organizing human retinal tissue. Nat Commun 6:6286
Kuwahara A, Nakano T, Eiraku M (2017) Generation of a three-dimensional retinal tissue from self-organizing human ESC culture. Methods Mol Biol 1597:17–29
Kuwahara A, Wijnholds J, Luyten GPM (2022) CRB1 gene therapy coming of age: mechanistic insight and rAAV assays on mouse and human retinal organoid models. Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
Lamba DA et al (2006) Efficient generation of retinal progenitor cells from human embryonic stem cells. Proc Natl Acad Sci U S A 103(34):12769–12774
Lamba DA et al (2010) Generation, purification and transplantation of photoreceptors derived from human induced pluripotent stem cells. PloS One 5(1):e8763
Lawrence M (2023) Human iPS cells for clinical applications and cellular products. Handb Exp Pharmacol
Leaver SG et al (2006) AAV-mediated expression of CNTF promotes long-term survival and regeneration of adult rat retinal ganglion cells. Gene Ther 13(18):1328–1341
Leong YC et al (2022) Molecular pathology of usher 1B patient-derived retinal organoids at single cell resolution. Stem Cell Rep 17(11):2421–2437
Leung A et al (2022) Investigation of PTC124-mediated translational readthrough in a retinal organoid model of AIPL1-associated Leber congenital amaurosis. Stem Cell Rep 17(10):2187–2202
Li G et al (2019) Generation and characterization of induced pluripotent stem cells and retinal organoids from a Leber's congenital amaurosis patient with novel RPE65 mutations. Front Mol Neurosci 12:212
Lin B et al (2020) Retina organoid transplants develop photoreceptors and improve visual function in RCS rats with RPE dysfunction. Invest Ophthalmol Vis Sci 61(11):34
Liu W et al (2000) All Brn3 genes can promote retinal ganglion cell differentiation in the chick. Development 127(15):3237–3247
Liu Z et al (2021a) Surgical transplantation of human RPE stem cell-derived RPE monolayers into non-human primates with immunosuppression. Stem Cell Rep 16(2):237–251
Liu H, Hua ZQ, Jin ZB (2021b) Modeling human retinoblastoma using embryonic stem cell-derived retinal organoids. STAR Protoc 2(2):100444
Luo Z et al (2021) Biodegradable scaffolds facilitate epiretinal transplantation of hiPSC-derived retinal neurons in nonhuman primates. Acta Biomater 134:289–301
Maeder ML et al (2019) Development of a gene-editing approach to restore vision loss in Leber congenital amaurosis type 10. Nat Med 25(2):229–233
Mattapally S et al (2018) Human leukocyte antigen class I and II knockout human induced pluripotent stem cell-derived cells: universal donor for cell therapy. J Am Heart Assoc 7(23):e010239
McClements ME et al (2022) Tropism of AAV vectors in photoreceptor-like cells of human iPSC-derived retinal organoids. Transl Vis Sci Technol 11(4):3
McGill MR et al (2012) Acetaminophen-induced liver injury in rats and mice: comparison of protein adducts, mitochondrial dysfunction, and oxidative stress in the mechanism of toxicity. Toxicol Appl Pharmacol 264(3):387–394
McLelland BT et al (2018) Transplanted hESC-derived retina organoid sheets differentiate, integrate, and improve visual function in retinal degenerate rats. Invest Ophthalmol Vis Sci 59(6):2586–2603
Menuchin-Lasowski Y et al (2022) SARS-CoV-2 infects and replicates in photoreceptor and retinal ganglion cells of human retinal organoids. Stem Cell Rep 17(4):789–803
Meyer JS et al (2009) Modeling early retinal development with human embryonic and induced pluripotent stem cells. Proc Natl Acad Sci U S A 106(39):16698–16703
Meyer JS et al (2011) Optic vesicle-like structures derived from human pluripotent stem cells facilitate a customized approach to retinal disease treatment. Stem Cells 29(8):1206–1218
Mohar I et al (2014) Acetaminophen-induced liver damage in mice is associated with gender-specific adduction of peroxiredoxin-6. Redox Biol 2:377–387
Mullin NK et al (2021) Patient derived stem cells for discovery and validation of novel pathogenic variants in inherited retinal disease. Prog Retin Eye Res 83:100918
Nakano T et al (2012) Self-formation of optic cups and storable stratified neural retina from human ESCs. Cell Stem Cell 10(6):771–785
Nakao N et al (2000) Promotion of survival and regeneration of nigral dopamine neurons in a rat model of Parkinson's disease after implantation of embryonal carcinoma-derived neurons genetically engineered to produce glial cell line-derived neurotrophic factor. J Neurosurg 92(4):659–670
Neves J et al (2016) Immune modulation by MANF promotes tissue repair and regenerative success in the retina. Science 353(6294):aaf3646
Nicholson A, Schumm SN, Beachy SH (2022) Understanding the role of the immune system in improving tissue regeneration: proceedings of a workshop. Washington
Norrie JL et al (2021) Retinoblastoma from human stem cell-derived retinal organoids. Nat Commun 12(1):4535
Oswald J et al (2021) Transplantation of miPSC/mESC-derived retinal ganglion cells into healthy and glaucomatous retinas. Mol Ther Methods Clin Dev 21:180–198
Ovando-Roche P et al (2018) Use of bioreactors for culturing human retinal organoids improves photoreceptor yields. Stem Cell Res Ther 9(1):156
Pearson RA et al (2010) Targeted disruption of outer limiting membrane junctional proteins (Crb1 and ZO-1) increases integration of transplanted photoreceptor precursors into the adult wild-type and degenerating retina. Cell Transplant 19(4):487–503
Petrus-Reurer S et al (2020) Generation of retinal pigment epithelial cells derived from human embryonic stem cells lacking human leukocyte antigen class I and II. Stem Cell Rep 14(4):648–662
Rabesandratana O et al (2020) Generation of a transplantable population of human iPSC-derived retinal ganglion cells. Front Cell Dev Biol 8:585675
Regent F et al (2022) Nicotinamide promotes formation of retinal organoids from human pluripotent stem cells via enhanced neural cell fate commitment. Front Cell Neurosci 16:878351
Reh TA, Lamba D, Gust J (2010) Directing human embryonic stem cells to a retinal fate. Methods Mol Biol 636:139–153
Reichel FFL et al (2021) An optimized treatment protocol for subretinal injections limits intravitreal vector distribution. Ophthalmol Sci 1(3):100050
Reichman S et al (2017) Generation of storable retinal organoids and retinal pigmented epithelium from adherent human iPS cells in Xeno-free and feeder-free conditions. Stem Cells 35(5):1176–1188
Ren R et al (2012) Long-term rescue of rat retinal ganglion cells and visual function by AAV-mediated BDNF expression after acute elevation of intraocular pressure. Invest Ophthalmol Vis Sci 53(2):1003–1011
Ribeiro J et al (2021) Restoration of visual function in advanced disease after transplantation of purified human pluripotent stem cell-derived cone photoreceptors. Cell Rep 35(3):109022
Ripolles-Garcia A et al (2022) Systemic immunosuppression promotes survival and integration of subretinally implanted human ESC-derived photoreceptor precursors in dogs. Stem Cell Rep 17(8):1824–1841
Rodrigues A et al (2022) Modeling PRPF31 retinitis pigmentosa using retinal pigment epithelium and organoids combined with gene augmentation rescue. NPJ Regen Med 7(1):39
Rozanska A et al (2022) pRB-depleted pluripotent stem cell retinal organoids recapitulate cell state transitions of retinoblastoma development and suggest an important role for pRB in retinal cell differentiation. Stem Cells Transl Med 11(4):415–433
Santos-Ferreira T et al (2016) Stem cell-derived photoreceptor transplants differentially integrate into mouse models of cone-rod dystrophy. Invest Ophthalmol Vis Sci 57(7):3509–3520
Shirai H et al (2016) Transplantation of human embryonic stem cell-derived retinal tissue in two primate models of retinal degeneration. Proc Natl Acad Sci U S A 113(1):E81–E90
Singh RK et al (2020) Development of a protocol for maintaining viability while shipping organoid-derived retinal tissue. J Tissue Eng Regen Med 14(2):388–394
Sridhar A et al (2020) Single-cell transcriptomic comparison of human fetal retina, hPSC-derived retinal organoids, and long-term retinal cultures. Cell Rep 30(5):1644–1659 e4
Stern J, Temple S (2015) Retinal pigment epithelial cell proliferation. Exp Biol Med (Maywood) 240(8):1079–1086
Su T et al (2022) Retinal organoids and microfluidic chip-based approaches to explore the retinitis pigmentosa with USH2A mutations. Front Bioeng Biotechnol 10:939774
Suh S et al (2021) Restoration of visual function in adult mice with an inherited retinal disease via adenine base editing. Nat Biomed Eng 5(2):169–178
Suzuki T et al (2003) Effects of prolonged delivery of brain-derived neurotrophic factor on the fate of neural stem cells transplanted into the developing rat retina. Biochem Biophys Res Commun 309(4):843–847
Suzuki N et al (2012) Establishment of retinal progenitor cell clones by transfection with Pax6 gene of mouse induced pluripotent stem (iPS) cells. Neurosci Lett 509(2):116–120
Thomas BB et al (2021) Co-grafts of human embryonic stem cell derived retina organoids and retinal pigment epithelium for retinal reconstruction in Immunodeficient retinal degenerate Royal College of Surgeons Rats. Front Neurosci 15:752958
Thomas ED et al (2022) Cell-specific cis-regulatory elements and mechanisms of non-coding genetic disease in human retina and retinal organoids. Dev Cell 57(6):820–836. e6
Tomita M et al (2006) A comparison of neural differentiation and retinal transplantation with bone marrow-derived cells and retinal progenitor cells. Stem Cells 24(10):2270–2278
Tucker BA et al (2011a) Transplantation of adult mouse iPS cell-derived photoreceptor precursors restores retinal structure and function in degenerative mice. PloS One 6(4):e18992
Tucker BA et al (2011b) Exome sequencing and analysis of induced pluripotent stem cells identify the cilia-related gene male germ cell-associated kinase (MAK) as a cause of retinitis pigmentosa. Proc Natl Acad Sci U S A 108(34):E569–E576
Tyson JA, Anderson SA (2014) GABAergic interneuron transplants to study development and treat disease. Trends Neurosci 37(3):169–177
Vaajasaari H et al (2011) Toward the defined and xeno-free differentiation of functional human pluripotent stem cell-derived retinal pigment epithelial cells. Mol Vis 17:558–575
Van Hoffelen SJ et al (2003) Incorporation of murine brain progenitor cells into the developing mammalian retina. Invest Ophthalmol Vis Sci 44(1):426–434
VanderWall KB et al (2019) Astrocytes regulate the development and maturation of retinal ganglion cells derived from human pluripotent stem cells. Stem Cell Rep 12(2):201–212
VanderWall KB et al (2020) Retinal ganglion cells with a glaucoma OPTN(E50K) mutation exhibit neurodegenerative phenotypes when derived from three-dimensional retinal organoids. Stem Cell Rep 15(1):52–66
Vargesson N (2015) Thalidomide-induced teratogenesis: history and mechanisms. Birth Defects Res C Embryo Today 105(2):140–156
Volkner M et al (2022) HBEGF-TNF induce a complex outer retinal pathology with photoreceptor cell extrusion in human organoids. Nat Commun 13(1):6183
Wang L et al (2018) Retinal cell type DNA methylation and histone modifications predict reprogramming efficiency and retinogenesis in 3D organoid cultures. Cell Rep 22(10):2601–2614
Wang ST et al (2019) Transplantation of retinal progenitor cells from optic cup-like structures differentiated from human embryonic stem cells in vitro and in vivo generation of retinal ganglion-like cells. Stem Cells Dev 28(4):258–267
West EL et al (2008) Pharmacological disruption of the outer limiting membrane leads to increased retinal integration of transplanted photoreceptor precursors. Exp Eye Res 86(4):601–611
West EL et al (2012) Manipulation of the recipient retinal environment by ectopic expression of neurotrophic growth factors can improve transplanted photoreceptor integration and survival. Cell Transplant 21(5):871–887
Xu H et al (2019) Targeted disruption of HLA genes via CRISPR-Cas9 generates iPSCs with enhanced immune compatibility. Cell Stem Cell 24(4):566–578 e7
Yoshida S et al (2022) A clinical-grade HLA haplobank of human induced pluripotent stem cells matching approximately 40% of the Japanese population. Med
Yue F et al (2010) Differentiation of primate ES cells into retinal cells induced by ES cell-derived pigmented cells. Biochem Biophys Res Commun 394(4):877–883
Zarbin M, Sugino I, Townes-Anderson E (2019) Concise review: update on retinal pigment epithelium transplantation for age-related macular degeneration. Stem Cells Transl Med 8(5):466–477
Zeng Y et al (2021) The impact of particulate matter (PM2.5) on human retinal development in hESC-derived retinal organoids. Front Cell Dev Biol 9:607341
Zhong X et al (2014) Generation of three-dimensional retinal tissue with functional photoreceptors from human iPSCs. Nat Commun 5:4047
Zhou J et al (2021) Human retinal organoids release extracellular vesicles that regulate gene expression in target human retinal progenitor cells. Sci Rep 11(1):21128
Zhu J et al (2017) Immunosuppression via loss of IL2rgamma enhances long-term functional integration of hESC-derived photoreceptors in the mouse retina. Cell Stem Cell 20(3):374–384 e5
Zou T et al (2019) Organoid-derived C-Kit(+)/SSEA4(−) human retinal progenitor cells promote a protective retinal microenvironment during transplantation in rodents. Nat Commun 10(1):1205
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Cheng, L., Kuehn, M.H. (2023). Human Retinal Organoids in Therapeutic Discovery: A Review of Applications. In: Kuehn, M.H., Zhu, W. (eds) Human iPSC-derived Disease Models for Drug Discovery. Handbook of Experimental Pharmacology, vol 281. Springer, Cham. https://doi.org/10.1007/164_2023_691
Download citation
DOI: https://doi.org/10.1007/164_2023_691
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-42348-2
Online ISBN: 978-3-031-42349-9
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)