Stem Cell Therapies in Ophthalmology: Promise and Perils

Abstract

In recent years, ophthalmology as a specialty has seen phenomenal shift in its therapeutic landscape. Despite advancements in traditional surgical and pharmacological ocular interventions, degenerative and hereditary ocular disease treatment mainly remains palliative rather than curative. In this wake, stem cell therapies have emerged as a frontier not just to treat but also restore cellular morphology and physiology to potentially restore vision. Ophthalmology is probably best suited for this regenerative therapy as the eye is relatively more accessible, optically transparent and immune privileged thereby reducing the risk of rejection.

Cornea has been the first frontier historically with regards to stem cell therapy. Subsequent to ocular trauma, chemical burn etc, limbal stem cell deficiency is being successfully treated by grafting of harvested limbal stem cells from patient’s healthy eye. Dental pulp of humans contain adult stem cells which like corneal stroma develop from the cranial neural crest. So theoretically they can also differentiate into keratocytes. Picard FNS and colleagues demonstrated such differentiation in mouse corneal stroma without affecting corneal transparency.