Abstract
Aim
To evaluate the long-term (1 year) functional and anatomical outcome of autologous translocation of peripheral choroid and retinal pigment epithelium (RPE) in 30 patients with age-related macular degeneration (AMD).
Methods
After the extraction of the neovascular complex, an autologous peripheral full-thickness graft of RPE and choroid was positioned under the macula. Functional tests included ETDRS vision, reading (Radner test), and microperimetry (scanning laser ophthalmoscope). Fluorescein, indocyanine green angiography, and autofluorescence were monitored.
Results
Preoperative visual acuity ranged from 20/40 to 20/800 (0.3–1.6 log MAR). Vision ranged from 20/25 to LP (0.1–2.1 log MAR) 1 year after surgery, with stabilization in six eyes, an increase in five eyes, and a decrease in 19 eyes. Deterioration mostly occurred within the first 3 months after surgery. In patients who demonstrated vascularization of the graft after 3 months, this persisted up to 12 months as did fixation when initially stable. Autofluorescence decreased significantly from 6 to 12 months postoperatively. Eleven cases showed a recurrence of choroidal neovascularization (CNV) within this period.
Conclusion
Patch translocation results in a viable graft. There is no evidence of graft failure within a 1-year follow-up. Nevertheless, there is risk for late CNV formation originating from the edges of the excision side of the CNV and growing peripheral to the graft.
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Acknowledgements
This paper was supported in part by the Deutsche Forschungsgemeinschaft (DFG) Jo 324/6-1 und 6-2 (Emmy Noether), Jo 324 /4-1, and Ki 743/5-1, and Ki 743 /2-1, the Brunnenbusch Stein Stiftung, the Glaser Stiftung and the RetinoVit Stiftung Köln. The authors have no proprietary interest in any of the materials used in this study.
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Heussen, F., Fawzy, N., Joeres, S. et al. Autologous translocation of the choroid and RPE in age-related macular degeneration: 1-year follow-up in 30 patients and recommendations for patient selection. Eye 22, 799–807 (2008). https://doi.org/10.1038/sj.eye.6702823
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DOI: https://doi.org/10.1038/sj.eye.6702823
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