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J.C. Van Meurs, P.R. van den Biesen; Autologous Retinal Pigmentepithelium and Choroid Translocation in Patients with Exsudative Age-related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2003;44(13):974.
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Purpose: To evaluate the feasibility to translocate autologous midperipheral retinal pigment epithelial (RPE) cells and choroid after the removal of a choroidal neovascular membrane in patients with subfoveal neovascular membranes in age-related macular dgeneration. Methods: Prospective evaluation of 6 patients with a follow-up of 6 to 13 months. All patients had a large (> 1 disk diameter) subfoveal choroidal membrane, 5 with subretinal hemorrhage. Preoperative vision ranged from 20/400 to 20/200. After extraction of the neovascular complex, an autologous full-thickness patch of RPE/Bruchs membrane/ choriocapillary and choroid was cut out from the midperiphery and repositioned under the macula. Functional tests included ETDRS vision, fixation testing on an optical coherence tomography monitor, fluorescein and indocyanide green angiography and scanning laser ophthalmoscopy autofluorescence. Results: The RPE patch appeared flat and had a brown furry aspect in 4 patients. Preferred fixation was on the patch in these 4 patients. Postoperative vision ranged from 20/200 to 20/64, with a two-line increase in 3 patients. Revascularization was visible on fluorescein and indocyanide angiography in 3 so examined patients. Viable RPE was demonstrated by almost normal autofluorescence over the patch in 4 patients. Conclusions: The translocation of a full-thickness patch with autologous peripheral RPE to the macula after choroidal neovascular membrane extraction was feasible and may result in a surviving and functioning graft for over one year. Longer follow-up to evaluate its long term benefit is necessary, as well as refinement of the surgery.
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