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Laura Bertazzi, Antonio Peroglio Deiro, Matteo Cereda, Grazia Pertile; Retinal Pigment Epithelium - Choroid Transplantation: results up to 3 years. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5814.
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To report and analyze functional and anatomical outcomes following an autologous retinal pigment epithelium (RPE) - choroid graft (PATCH) transplantation in patients with neovascular macular degeneration.
Retrospective analysis of 72 patients who underwent a RPE-choroid transplantation between April 2007 and November 2011. All patients had a subfoveal choroidal neovascularization (CNV) with or without haemorrhage or an RPE tear. All were either ineligible for or non-responsive to conventional therapy. SD-OCT and fluorescein angiography (FA) combined with indocyanine green angiography (ICGA) examinations were obtained using Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) before surgery and during follow-up. Preoperative and postoperative best-corrected visual acuity (BCVA) measurements were performed using ETDRS charts.
72 consecutive patients (38 female, 34 male) underwent RPE-choroid graft surgery. The mean age was 73 years (range: 34-88). Medium followup was 20±13 months. The mean preoperative BCVA was 1.5 logMAR. Mean postoperative BCVA was 1.2 logMAR. The BCVA rimained stable or improved in 52 out of 72 eyes. Mean graft's revascularization time was 31 days. Severe complications were reported in 15 eyes (20%): 9 submacular haemorragies, 2 macular holes, 2 retinal detachment, 2 lack of vascularization of the choroidal grafts. Three (4%) eyes developed a recurrent subfoveal choroidal neovascularization during the follow-up.
RPE-choroid graft transplantation has the potential to maintain or restore macular function in selected eyes affected by subfoveal CNV, with low recurrence rates. Retinal sensitivity, BCVA data, and fixation on the graft suggest that the graft was responsible for the preservation of the macular function. This surgery may represent an alternative for patients with exudative AMD that cannot benefit from anti-VEGF therapy.
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