Analysis of intraocular amniotic membrane in vitreoretinal disease with complicated retinal detachment - case reports and in-vitro safety assessment.

Purpose: Amniotic membrane (AM) is a popular treatment for ocular surface diseases due to its wound healing effects. First intraocular implantations showed good anatomical and functional results. Here, three cases of intravitreal AM transplantation and the morphological and functional outcome are described. The reaction to AM was examined by immunostaining and cellular reactions were investigated on retinal cells in-vitro. Methods: Three patients with epiretinal implanted AM during PPV for complicated retinal detachment are presented retrospectively. We investigated the AM-influence in-vitro on RPE cells (ARPE-19), Müller cells (Mio-M1), and retinoblasts (661W). An anti-histone DNA ELISA and live/dead assay for apoptosis, a BrdU ELISA for proliferation and a WST-1 assay for viability were performed. Following AM-removal, tissue-specific cellular responses were evaluated by light microscopy and immunohistochemical staining. Results: Despite severe vitreoretinal disease, good anatomical and functional outcomes were achieved in all three cases. Immunostaining of AM showed no immunological rejection. In-vitro, AM mediates no toxic or proliferating effect on RPE and Müller cells but a neuroprotective effect on differentiated retinoblasts. Conclusion: AM offers possible advantages treating severe vitreoretinal disease. The pathobiological mode of action was elucidated and we could not determine issues regarding rejection reactions and biocompatibility. Further studies are needed to assess clinical potential.