by Les Cole, MD, ABAARM, ABIHM

Regenerative medicine has the potential to fill significant gaps in our ability to treat many health conditions. It is tremendously powerful medicine. Research is showing that it also has applications for a number of eye conditions for which there are few effective therapies. If you have one of these eye conditions, you may find the research very encouraging.

Optic Nerve Damage

Non-arteritic ischemic optic neuropathy (NAION): In the patients with visual loss from NAION (loss duration from 1 to 35 years, average 9 years), 73.6 percent of eyes treated had an average improvement of 3.53 lines of vision per eye.

Other optic nerve diseases that showed improvement in the same Stem Cell Ophthalmology Treatment Study (SCOTS) include Leber’s Optic Atrophy: Visual acuity gains of up to 35 letters on the Snellen Chart and improved visual fields; Dominant Optic Atrophy: 83.3 percent experienced gains in visual acuity with a median improvement of 2.125 Snellen lines; Autoimmune Optic Neuropathy: (multiple sclerosis and Devic’s disease) only one patient but both eyes had profound improvements in both visual acuity and visual fields.

Glaucoma is a leading cause of blindness. A 2019 review article shows stem cells and their exosomes can repair optic nerve damage and retinal ganglion cells and stimulate retinal stem cells to become new retinal ganglion cells and thus induce “alleviation of glaucoma”.

Retinal Damage

Retinitis pigmentosa is due to a cluster of genetic mutations and relatively rare. It is, however, a model for most degenerative retinal diseases because it is so severe and causes damage of all retinal layers. It starts at a young age and leads to both loss of visual acuity and peripheral vision and damages most retinal cells. This fact makes the SCOTS (study) of Retinitis Pigmentosa results profound. This is a progressive disease meaning vision continually declines.

In this study, 17 patients were treated with mesenchymal stem cells (MSCs) which secrete exosomes as their mechanism of acting on adjacent tissues. The average duration of disease prior to treatment was 27.6 years and ranged from 4 to approximately 60 years. Treated with MSCs and their exosomes were 33 eyes with the results: 15 eyes (45.5 percent) improved an average of 7.9 lines of Snellen acuity; 15 eyes (45.5 percent) remained stable; and 3 eyes (9 percent) worsened by an average of 1.7 lines. So, in 30 eyes, the vision was improved or stabilized during the treatment period and only three eyes had progressive vision loss.

This has implications for most retinal degenerative diseases: Age related dry macular degeneration (AMD), a leading cause of blindness along with glaucoma, Stargardt's disease, serpiginous chorioretinopathy, etc. The recent research for all of these conditions isn’t whether or not to use stem cells and their exosomes, but which stem cells and exosomes to use.

Dr. Les Cole has his practice at St. Petersburg Health & Wellness, located at 2100 Dr. MLK Jr. St. N, St. Petersburg. For more information and appointments, call 727-202-6807 or email [email protected].