What your patient might ask you…

Did you hear about those women who went blind after a stem cell treatment?

You probably did because this article is everywhere (CBSNBCNPRNY Daily NewsNYTWashington Post etc) but here is your rundown.
paper published in the New England Journal of Medicine details three elderly women with AMD who received intravitreal injections of adipose tissue–derived “stem cells”.   Before the injection, vision ranged from 20/30 to 20/200.  After the injection vision was 20/200 to LP vision.  The patients underwent the procedure at a stem cell clinic in Florida that had an approved research trial listed on ClinicalTrials.gov at the time.  At least one patient believed they were taking part in a clinical trial.

Why did the vision get worse?
A variety of reasons including ocular hypertension, hemorrhagic retinopathy, vitreous hemorrhage, retinal detachment and lens dislocation.

What was in the injection?
It supposedly contained stem cells that were obtained from fat removed from their abdomen through liposuction.

Did the patient pay for it? 
Yes, $5000 for the bilateral procedure.  Bilateral intravitreal injections were done on the same day.

What did the study sponsor say? 
The scientific director stated the stem cell procedures were discontinued after at least two patients suffered detached retinas but defended the use of stem cells from fat tissue to treat a wide variety of other health problems.
“We have treated more than 7,000 patients and we’ve have had very few adverse events reported. So the safety track record is very strong.” 

What are the experts saying?
Beware the snake oil salesman. There is a difference between a meticulously designed stem cell clinical trial for AMD and a “poorly defined slurry” of stem cell treatments touted as regenerative stem cell therapy.  We are still learning how stem cells can be manufactured and delivered safely to integrate into existing tissue architecture and restore function.

Jaclyn Garlich
Dr. Garlich graduated from the New England College of Optometry in 2010 and completed a residency in primary care and ocular disease at the St. Louis VA. In 2013, she developed an optometry clinical reference mobile app available in the iTunes store. In 2016, she founded 20/20 Glance, a weekly optometry newsletter that gives a rundown on clinically relevant optometry news in an easy to digest format.

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