Abstract
Purpose
To analyse structural changes after autologous translocation of choroid and retinal pigment epithelium (RPE) in patients with age-related macular degeneration (AMD) using optical coherence tomography (OCT).
Methods
We performed a prospective nonrandomised study in 29 consecutive patients, who underwent submacular surgery with translocation of an autologous full-thickness graft of RPE, Bruch's membrane, and choroid. All patients had recent loss of reading vision due to AMD. OCT was performed before surgery and at 3- and 6- month follow-up to analyse the morphological appearance of the graft and the overlying retina.
Results
Maximum retinal thickness decreased from mean 408 μm (standard deviation (SD) 127 μm) preoperative to mean 373 μm (SD 104 μm) at 6-month follow-up (P=0.094). In 11 cases (40%), a nearly physiological shape of the retina was seen at this time point. A macular hole persisted in two eyes after silicone oil removal. In most eyes, the highly reflective band of the graft presumably corresponding to RPE was continuous with the surrounding RPE band in all six OCT scans. Eyes with flat appearance of the graft at 6-month follow-up (<300 μm) showed a significantly better functional outcome than eyes with more prominent grafts. Interestingly, most patients did not complain about metamorphopsia, even though the graft was prominent or wrinkled in some cases.
Conclusion
OCT is a useful tool in monitoring intra- and subretinal changes after subretinal surgery with graft translocation. We demonstrated that graft translocation may lead to a normalisation of retinal thickness and stabilisation of visual acuity.
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Acknowledgements
We thank Beate Prinz and Erica Menrath for expert technical assistance. This work was supported by DFG Jo 324/6-2 (Emmy Noether) and DFG Ki 743/5-1.
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Joeres, S., Llacer, H., Heussen, F. et al. Optical coherence tomography on autologous translocation of choroid and retinal pigment epithelium in age-related macular degeneration. Eye 22, 782–789 (2008). https://doi.org/10.1038/sj.eye.6702761
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DOI: https://doi.org/10.1038/sj.eye.6702761
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