Subtenon Implantation of Wharton’s Jelly Derived Mesenchymal Stromal Cell for Retinitis Pigmentosa: A 1 – 2 Year Follow-Up Report

Abstract

Background: Retinitis Pigmentosa (RP) is a group of genetically inherited retinal dystrophies characterized by the progressive degeneration of photoreceptors, leading to irreversible vision loss. With limited therapeutic options currently available, stem cell therapy has emerged as a promising regenerative strategy for retinal repair and vision restoration.

Objective: The study aimed to evaluate the safety, feasibility, and potential therapeutic effects of subtenon implantation of human Wharton's Jelly-derived Mesenchymal Stem Cells (WJ-MSCs) by inhibiting proinflammatory cytokine expression, thereby suppressing chronic retinal inflammation and preventing apoptosis of photoreceptor cells. 

Materials and Methods: We present four case illustrations of patients diagnosed with RP who were treated with WJ-MSCs injected in the deep subtenon space. Each patient received a total of four injection sessions between November 2020 and January 2023. The procedure was well tolerated in all sessions, and patients were monitored closely for clinical outcomes and potential adverse effects. 

Result: Patients 1 and 2 underwent a more intensive treatment regimen with 7 subtenon WJ-MSC injection over a 24-month period. This approach aimed to provide sustained therapeutic effects, with both patients reporting stable visual improvements and no adverse events during the follow-up period. Moreover, both patients 3 and 4 received a shorter treatment course with 3 subtenon WJ-MSC injection over 12 months. Despite the reduced number of injection, both patients experienced intermittent episodes of brighter vision, suggesting potential therapeutic benefits. The study found significant improvements in best corrected visual acuity, outer retinal thickness, and full-field electroretinography parameters, supporting the potential benefits of this treatment modality. Our study involving 4 patients with RP demonstrated that subtenon administration with hWJ-MSC treatment was found to be effective and safe, with no serious adverse events or ophthalmic/systemic side effects reported during the follow-up period. 

Conclusion:These findings align with previous study, supporting the safety and efficacy of subtenon hWJ-MSC administration in RP patients and suggesting it as a promising therapeutic approach.