Advancements in Ocular Regenerative Therapies

Abstract

The use of stem cells (SCs) has emerged as a promising avenue in ophthalmology, offering potential therapeutic solutions for various vision impairments and degenerative eye diseases. SCs possess the unique ability to self-renew and differentiate into specialised cell types, making them valuable tools for repairing damaged tissues and restoring visual function. Stem cell-based therapies hold significant potential for addressing conditions such as age-related macular degeneration (AMD), retinitis pigmentosa (RP), corneal disorders, and optic nerve damage. Therefore, researchers have explored different sources of stem cells, including embryonic stem cells (ESC), induced pluripotent stem cells (iPSCs), and adult stem cells, for ocular tissue regeneration. Preclinical studies and early-phase clinical trials have demonstrated promising outcomes, with some patients experiencing improved vision following stem cell-based interventions. However, several challenges remain, including optimising the differentiation protocols, ensuring transplanted cells’ safety and long-term viability, and developing effective delivery methods. The field of stem cell research in ophthalmology witnesses a constant influx of new reports and discoveries. To effectively navigate these tons of information, it becomes crucial to summarise and systematise these findings periodically. In light of recent discoveries, this paper demonstrates the potential applications of stem cells in ophthalmology, focusing on their use in various eye tissues, including the cornea, retina, conjunctiva, iris, trabecular meshwork, lens, ciliary body, sclera, and orbital fat.

Seeing the Future: A Review of Ocular Therapy

“…The source of the stem-like cell population depends upon the target cell type. Cell therapies for corneal disease are the most commonly researched among anterior segment diseases, owing to the immune privilege status of the cornea, which would prevent the graft rejection immune response [57]. Corneal therapies are derived from limbal stem cells (LSCs) and mesenchymal stem cells (MSCs).…”

“…LSCs are a population of stem cells that are located in the palisade of the Vogt region in the limbus and contribute to corneal cell replacement and regeneration after corneal injury. The unique regenerative capacity of LSCs, combined with their accessible location, makes LSCs a prime candidate for cell therapies to treat corneal injuries [57]. Corneal burns and injuries in the limbal region can lead to the loss of this stem cell population, resulting in conjunctival invasion of the cornea and neovascularization, reducing corneal transparency and leading to vision loss.…”

“…Corneal burns and injuries in the limbal region can lead to the loss of this stem cell population, resulting in conjunctival invasion of the cornea and neovascularization, reducing corneal transparency and leading to vision loss. Consequently, repopulation of the limbal region with LSC therapy is currently under study for the treatment of corneal disorders resulting in opacification [57]. LSCs for transplantation can be derived from a variety of tissue types, including the conjunctiva and the keratolimbal regions, and from either live donors or cadavers, while transplants can be derived from the patient, which are autologous transplants as opposed to allogenic transplants from a donor [57,58].…”

“…Consequently, repopulation of the limbal region with LSC therapy is currently under study for the treatment of corneal disorders resulting in opacification [57]. LSCs for transplantation can be derived from a variety of tissue types, including the conjunctiva and the keratolimbal regions, and from either live donors or cadavers, while transplants can be derived from the patient, which are autologous transplants as opposed to allogenic transplants from a donor [57,58]. The most widely used method is the conjunctival-limbal autograft, owing to its success compared with other methods, and involves the transplantation of a piece of limbal tissue from the contralateral eye of the same patient [57].…”

“…LSCs for transplantation can be derived from a variety of tissue types, including the conjunctiva and the keratolimbal regions, and from either live donors or cadavers, while transplants can be derived from the patient, which are autologous transplants as opposed to allogenic transplants from a donor [57,58]. The most widely used method is the conjunctival-limbal autograft, owing to its success compared with other methods, and involves the transplantation of a piece of limbal tissue from the contralateral eye of the same patient [57]. The biggest disadvantage is that this procedure requires transplantation of up to one-third of the limbal tissue from the contralateral eye and could result in damage to the healthy eye [59,60].…”