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Stem cell treatment of the patient with Best\'s disease

Patient B. aged 18 has been followed-up for 3 years for Best’s dystrophy OU.

First symptoms appeared at the age of 9. At the age of 12, she was examined and treated in V.P. Filatov National Research and Development Institute for Eye Diseases and Tissue Therapy for dystrophy, neuroretinitis OU, exudative macular dystrophy of the left eye.

Ophthalmoscopy findings: no signs of irritation, cornea – clear, marked opacity in the vitreous body. Marked hyperemia of optic discs, their borders are blurred, arteries are diluted and tortuous. OD: lesion sizing 1.0 D in the macula, borders are somewhat blurred; OS: marked edema, lesion sizing 1.0 D in the macula without clear borders.
Visus: OD – 0.25 (not corrected), corrected – 1.0=0.3; OS – 0.05 (not corrected), corrected – 1.0 = 0.08. She was found positive for toxoplasmosis – 3++++.
Treatment: dexamethasone, fibrinolysin, etamsylate, ATP, vitamins C, B2, dehydration.
Results: marked regression of opacity in the vitreous body, borders of optic discs became clear, partial resolving of macular edema.
Corrected visus: OD – 1.0, OS – 0.4.

At the age of 13, exudative macular dystrophy OU was diagnosed.
Visus: OD – 1,0, OS – 0,35.
Treatment: actovegin, plasmol, vitamin C, nicotine acid.

Diagnosis at the age of 14 – macular dystrophy OD, chorioretinitis OS.
Ophthalmoscopy findings: no signs of irritation, cornea – clear. No precipitation.
OD: Opacity in the vitreous body. Optic disc – pink with clear borders. Degeneration focus sizing 1 D with clear borders in the macula.
OS: chorioretinal focus sizing 1 D in the macula, reduction of edematic zone after laser coagulation.
Treatment: FIBS, vitamin C, etamsylate, emoxipine, nicotine acid, phonophoresis with Encadum, autotransfusion.
Uncorrected visus: OD – 0.7 before treatment and 1.0 after treatment; OS – 0.3 before treatment and 0.35 after treatment.

Diagnosis at the age of 15 – exudative macular degeneration OU.
Ophthalmoscopy findings: no signs of irritation, no precipitation, opaque floaters in the vitreous body. Optic disc – pink, blurred borders, markedly reduced edema in the macula, laser coagulation lesions, lesion with clear borders. Presently, the patient prefers to abstain from laser coagulation OD.
Treatment: plasmol, vitamin C, dexamethasone, diclofenac, calcium gluconate.
Uncorrected visus: OD – 0.3 before the treatment and 0,6 after the treatment; OS – 0.35 before the treatment and 0.4-0.5 after the treatment.
One month later, in October 2000, Best’s disease (central retinal abiotrophy) was diagnosed. Marked deterioration of the retina OU. Marked retinal edema with the cyst in the central fovea. Ms. B cannot read and writes blindly.

October 2000 – I stem cell therapy course: administration of 1.2 ml of fetal stem cell suspension via drip-feed IV repeated on Day 3 in the amount of 1.0 ml. Treatment was tolerated well and no side effects were reported.

November 2000 ophthalmoscopy findings: OD: uncorrected visus – 0.4. Optic disc has clear contours, pale pink. Arteries are not diluted. 0.5 D yellow cyst under pigment epithelium of the macula. OS: uncorrected visus – 0.3. Optic disc has clear contours, pale pink. Arteries are not diluted. 1 D dystrophic lesion (after cyst dissolution) with pigment deposit in the macula. Paramacular lesions after laser coagulation.
II stem cell therapy course: administration of 0.3 ml of fetal stem cell suspension via drip-feed IV followed by subcutaneous implantation of 1.4 ml of the same suspension. Treatment was tolerated well and no side effects were reported.

In mid-December of 2000, Ms. B started to read without pain in her eyes. Her eyes get tired after 20 minutes of writing. Positive changes in the left eye: “tire” diameter decreased making the light space inside larger. Central spot (“wheel axis”) shifted upwards to the right, which enables Ms. B to see small details, like interlocutor’s color of the eyes.

27.01.01. Ophthalmoscopy findings: OD: uncorrected visus – 0.4. Anterior segment is unchanged. Optic media are clear. Fundus: Optic disc has clear contours, pale pink. Arteries are not diluted. 0.5 D yellowish-orange cyst under pigment epithelium of the macula. Images provide clear evidence of micro-hemorrhagic lesion dissolution in the center of the cyst (in comparison with 25.11.2000).
OS: uncorrected visus – 0.4. Anterior segment is unchanged. Optic media are clear. Fundus: Optic disc has clear contours, pale pink. Arteries are not diluted. 1 D dystrophic lesion (after cyst dissolution) with pigment deposit in the macula. Paramacular lesions after laser coagulation.
Images provide clear evidence of micro-hemorrhagic lesion dissolution in the center of the cyst (in comparison with 25.11.2000).
III stem cell therapy course: implantation of 1.4 ml of the same fetal stem cell suspension. Treatment was tolerated well and no side effects were reported.
In April 2001, no marked changes were reported: her eyes still hurt after 15-20 minutes of strain (reading, writing, watching TV).

23.04.01 Ophthalmoscopy findings: OD: uncorrected visus – 0.2, corrected – 0.5-0.3. Positive changes: OD – Optic disc has clear contours, pale pink. Arteries are not diluted. 0.5 D yellowish-orange cyst under pigment epithelium of the macula.
OS: uncorrected visus – 0.3. Anterior segment is unchanged. Optic media are clear. Fundus: Optic disc has clear contours, pale pink. Arteries are not diluted. 1 D dystrophic lesion (after cyst dissolution) with pigment deposit in the macula. Paramacular lesions after laser coagulation.

10.05.01 – IV stem cell therapy course: implantation of 1.4 ml of the same fetal stem cell suspension.

02.08.01 – V stem cell therapy course: administration of 3.6 ml of fetal stem cell suspension via drip-feed IV.

06.12.01. Ophthalmoscopy findings: OD: uncorrected visus – 0.1, corrected – 0.3. Optic media are clear. Fundus: Optic disc has clear contours, pale pink. Arteries are not diluted. 0.5 D dystrophic lesion with pigment deposit in the macula.
OS: uncorrected visus – 0.2, corrected – 0.3. Anterior segment is unchanged. Optic media are clear. Fundus: Optic disc has clear contours, pale pink. Arteries are not diluted. 1 D dystrophic lesion (after cyst dissolution) with pigment deposit in the macula. Paramacular lesions after laser coagulation.

Presently, the patient’s condition is satisfactory, she lives in a foreign country on her own, studies foreign languages and works.

Fetal stem cells treatment results depend on: disease's severity, age of the patient, adherence for the medications and regime. Treatment results, presented on this site, are individual for each clinical case.