Intravitreal autologous bone marrow-derived mononuclear cell transplantation: a feasibility report

Purpose: To report on the feasibility and safety of an intravitreal injection of mononuclear cells derived from autologous bone marrow. Methods: A 43-year-old patient with very advanced atrophy of the retina and optic nerve caused by diabetic retinopathy had undergone pars plana vitrectomy with silicone oil endotamponade. Despite complete retinal attachment, vision was limited to defective light perception as a result of retinal capillary occlusion. As an ultima ratio, the patient underwent an intravitreal injection of autologous bone marrow-derived stem cells obtained by isolating mononuclear cells from 100 ml of bone marrow. Results: On postoperative day 1, a cluster of injected cells was observed on the retinal surface in the inferior fundus periphery. The anterior chamber was completely filled with silicone oil, which was released transcorneally. Subsequently, intraocular pressure remained normal and the anterior chamber was free of inflammatory cells or flare. Within 1 week of the injection, visual acuity remained at light perception. There were no signs of any side-effects of the therapy, such as inflammation or infection. Conclusions: Intravitreal autologous bone marrow mononuclear cell transplantation is technically feasible.