The most common cause of untreatable vision loss is dysfunction of the retina. Conditions, such as age-related macular degeneration, diabetic retinopathy and glaucoma remain leading causes of untreatable blindness worldwide. Various stem cell approaches are being explored for treatment of retinal regeneration. The rationale for using bone marrow stem cells to treat retinal dysfunction is based on preclinical evidence showing that bone marrow stem cells can rescue degenerating and ischemic retina. These stem cells have primarily paracrine trophic effects although some cells can directly incorporate into damaged tissue. Since the paracrine trophic effects can have regenerative effects on multiple cells in the retina, the use of this cell therapy is not limited to a particular retinal condition. Autologous bone marrow-derived stem cells are being explored in early clinical trials as therapy for various retinal conditions. These bone marrow stem cells include mesenchymal stem cells, mononuclear cells and CD34⁺ cells. Autologous therapy requires no systemic immunosuppression or donor matching. Intravitreal delivery of CD34⁺ cells and mononuclear cells appears to be tolerated and is being explored since some of these cells can home into the damaged retina after intravitreal administration. The safety of intravitreal delivery of mesenchymal stem cells has not been well established. This review provides an update of the current evidence in support of the use of bone marrow stem cells as treatment for retinal dysfunction. The potential limitations and complications of using certain forms of bone marrow stem cells as therapy are discussed. Future directions of research include methods to optimize the therapeutic potential of these stem cells, non-cellular alternatives using extracellular vesicles, and in vivo high-resolution retinal imaging to detect cellular changes in the retina following cell therapy.

不可治愈的视力丧失的最常见原因是视网膜功能障碍。诸如年龄相关性黄斑变性，糖尿病性视网膜病变和青光眼等疾病仍然是全球范围内无法治愈的失明的主要原因。人们正在探索各种干细胞治疗视网膜再生的方法。使用骨髓干细胞治疗视网膜功能障碍的基本原理是基于临床前证据表明，骨髓干细胞可以挽救变性和缺血性视网膜。这些干细胞主要具有旁分泌营养作用，尽管有些细胞可以直接掺入受损的组织中。由于旁分泌营养作用可对视网膜中的多个细胞产生再生作用，因此该细胞疗法的使用不限于特定的视网膜疾病。在早期的临床试验中，自体骨髓来源的干细胞正在探索作为各种视网膜疾病的治疗方法。这些骨髓干细胞包括间充质干细胞，单核细胞和CD34⁺细胞。自体疗法不需要全身免疫抑制或供体匹配。玻璃体内注射CD34 ⁺细胞和单核细胞似乎是可以耐受的，并且正在研究中，因为玻璃体内注射后这些细胞中的一些可以进入受损的视网膜。玻璃体内递送间充质干细胞的安全性尚未得到很好的确定。这篇综述提供了支持使用骨髓干细胞治疗视网膜功能障碍的最新证据。讨论了使用某些形式的骨髓干细胞作为治疗方法的潜在局限性和并发症。未来的研究方向包括优化这些干细胞的治疗潜力的方法，使用细胞外囊泡的非细胞替代物以及体内高分辨率视网膜成像以检测细胞治疗后视网膜中的细胞变化。