Abstract: Retinal pigment epithelium (RPE) cell replacement therapy is a potential method for the treatment of retinal degenerative disease. Unique advantages for RPE cell replacement therapy exist in treatment for the eye. Alternative RPE cells can derive from both stem cells and somatic cells. The former includes embryonic stem cell (ESC)-RPE and induced pluripotent stem cell (iPSC)-RPE. The latter is divided into adult origin (autologous or allogeneic) and fetal origin (Fetal-RPE). The clinical research of RPE cell replacement therapy is still in the early stage. At present, human ESC-RPE, human iPSC-RPE, and human Fetal-RPE cell replacement therapy for retinal degenerative diseases are all still in the preclinical and clinical research stages. In clinical trials, the visual function of some patients has improved, but neither ESC-RPE nor Fetal-RPE can avoid immune rejection. The complications of immunosuppressive agents are also worthy of attention. Whether the transplanted cells can survive for a long time needs further observation. The iPSC induction regimen, the method of ESC and iPSC differentiation into RPE cells have not formed a unified and standardized guide. Reasonable treatment time window, improvement of cell graft production and transplantation are the keys to ensure the effect of treatment. (Int Rev Ophthalmol,  2020,  44:  419-426)

Key words: retinal degenerative diseases, retinal pigment epithelial cells, cell transplantation