Surgical management of age-related macular degeneration

Cell-based therapy for retina degeneration: the promise of a cure

Cell-based therapies in the retina have been associated with the recovery of visual function in animal models of retinal degeneration. This review covers the current status of such therapies with regard to the source of the donor cells, their integration, and their impact on the degenerating host retina. Emphasis is also put on the importance of a careful interpretation of what is meant by "recovery of visual function". Two main approaches are considered here: (1) the use of human embryonic stem cell derived retinal pigment epithelial (RPE) cells to rescue photoreceptors in an animal model of RPE defect; and (2) the use of photoreceptor precursors to repair the degenerating neural retina. The current conclusions are that major hurdles have to be dealt with, such as finding an appropriate and ethically compliant donor cell source that would yield protracted survival and integration of the replacement retinal cells, and that there is no evidence yet that cell-based therapies can allow the long-term preservation or recovery of conscious vision.

Surgical treatment of low vision

Recent advances in technology are driving a renewed search to find surgical solutions for low vision rehabilitation. The scope of surgery is now being pushed beyond the initial goal of repairing existing anatomical structures. Today, the goal for vision rehabilitation is no less than replacing damaged ocular tissues with artificial ones. Surgical management of low vision may be subdivided into two categories, those procedures aimed at restoring ultrastructural visual function and those aimed at enhancing visual acuity of the residual retina with various levels of magnification. This paper briefly reviews advances in ultrastructural restoration by repair and considers in more detail enhanced acuity through magnification or replacement.