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Dec 9, 2019

Stem cell treatment: What could possibly go wrong with procedure?

By: Lynda Charters

Abstract / Synopsis: 

Stem cell therapies for ocular diseases often are of unproven efficacy and may result in vision loss, notes one surgeon.

Reviewed by Thomas A. Albini, MD

Stem cell technology is a rapidly growing, highly lucrative industry serving thousands of patients. With the opportunities it can present, people with nefarious intentions will seek to take advantages of patients with chronic diseases who are looking for a glimmer of hope. However, ophthalmologists are warning that the booming industry, which promises better health, including improved vision, can leave patients disappointed, frustrated, and in worse condition after the treatments.

According to Thomas A. Albini, MD, businesses have opened their doors to target patients with macular degeneration, diabetic retinopathy, and retinitis pigmentosa with sophisticated TV ads that tout expensive stem cell treatments. One company provides a customized stem cell eye drop using autologous stem cells for treating end-stage glaucoma.

The drops cost $5,000 per bottle and when questioned, the company told Dr. Albini that the more months of therapy the patient had the better and no data supports the treatment. Dr. Albini, professor clinical ophthalmology, Bascom Palmer Eye Institute, University of Miami, said he began to focus on the industries after two patients came to his practice after undergoing stem cell treatments for age-related macular degeneration (AMD) at a Broward County, FL, clinic.

Patient saw a ‘specialist’

The first patient, a 78-year-old woman had undergone bilateral simultaneous intravitreal injections of autologous adipose tissue-derived stem cells, which were administered by a “stem cell specialist” who was not an MD. The woman’s previous retina specialist told Dr. Albini that the patient had wet AMD treated with multiple anti-vascular endothelial growth factor drug injections; the visual acuities (VAs) at that time were 20/50 and 20/100 in the right and left eyes, respectively.

Two days after the stem cell injection, she presented with minimal inflammation, vitreal hemorrhages, and the presence of an adipose tissue mass bilaterally. On days 16 and 38, rhegmatogenous retinal detachments developed in the right and left eyes; surgery was performed. The VAs at 12 months were hand motions and 20/200. The second patient, a 72-year-old woman, presented with pain and decreased VA to counting fingers three days after having been treated at the same stem cell clinic.

She had a history of dry AMD with VAs of 20/60 and 20/30 in the right and left eyes, respectively. Bilateral stem cell injections were administered resulting in bilateral crystalline lens subluxation, vitreous hemorrhage, and an acute intraocular pressure spike to 60 mm Hg. Emergency bilateral vitrectomies were performed for endophthalmitis, during which a retinal detachment was found in one eye.

The VAs at 12 months were no light perception bilaterally. Both cases were reported to the Therapeutic Surveillance Committee of the American Society of Refractive Surgeons, which knew of a third patient treated at the same clinic. That patient had dry AMD and following treatment after 12 months the VAs were hand motions and light perception in the right and left eyes, respectively, as a result of traction rhegmatogenous detachments and proliferative vitreoretinopathy……

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Source: Ophthalmology Times

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