年龄相关性黄斑变性（ age-related macular degeneration，AMD）是与年龄相关致盲的重要眼病之一，分为干性和湿性。目前干性 AMD尚无有效的根本性治疗方法。视网膜色素上皮（ retinal pigment epithelium，RPE）位于神经视网膜和脉络膜之间，对感光细胞的存活和正常功能的维持有重要意义。在 AMD中 RPE细胞的结构和生理功能的衰老导致 Bruchs膜、脉络膜血管和光感受器细胞退行性改变，从而影响其代谢和功能，最终导致感光细胞死亡，视功能不可逆损伤。自 1991年来研究者开始尝试 RPE细胞的替代治疗。随着多能干细胞体外诱导分化技术逐渐成熟，干细胞定向分化 RPE细胞的移植治疗正在成为填充和置换已受损细胞从而治疗 AMD的一种新策略。该文从 AMD的细胞替代治疗中 RPE干细胞的来源、 RPE细胞定向分化的鉴定、 RPE细胞的移植技术以及相关临床试验等方面对其研究进展进行综述。

Age-related macular degeneration (AMD) is one of the leading causes of irreversible vision loss related with aging, including wet AMD and dry AMD. At present, there is still no effective treatment for dry AMD. Retinal pigment epithelium (RPE), located between the retina and the choroid, plays an important role in the survival of photoreceptor and maintenance of its physiological function. In AMD patients, the aging of RPE leads to degeneration and dysfunction of Bruch’s membrane, choroidal and photoreceptor, thus causing the loss of the retina photoreceptor cells. Since 1991, researchers have been trying various replacement therapies of RPE cells. With the development of technique for induction and differentiation of pluripotent stem cells (PSC) in vitro, the transplantation of stem cells differentiating into RPE cells is going to be a feasible strategy for replacing impaired RPE cells in AMD. This article reviewed the advances in the study of the source of RPE cells, identification of cell differentiation, transplantation and the related clinical trials in cell replacement therapy of AMD.