Purchase this article with an account.
E. J. Van Zeeburg, K. J. M. Maaijwee, R. Wubbels, J. C. van Meurs; Four-Year Visual Outcome of a Retinal Pigment Epithelium-Choroid Graft in Patients With Exudative Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2058.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To analyze visual acuity outcome 4 years after RPE-choroid graft translocation in patients with exudative age-related macular degeneration.
We prospectively studied a cohort of 132 patients (135 eyes), who had undergone a RPE-choroid graft surgery 4 years or more before the censoring date, November 30, 2009. When the first patient underwent surgery in October 2001 PDT was standard treatment, whereas Avastin became available in 2006. Only patients not eligible for either of these treatments were selected for surgery. Preop- and 4 year-postop EDTRS visual acuity (VA) were analyzed.
The mean preop VA (logMar) of all patients (135 eyes) was 1.106 (20/255). When LOCF was applied to 12 patients with a >20/200 VA and 71 patients with a 20/200 or worse VA with incomplete follow up, the mean 4-year VA of all patients (135 eyes) was 1.351 = 20/448, a 2.5 line drop.When 12 patients lost to follow up with a VA better than 20/200 were excluded, there was a 1-3, 4-6, 7-9, 10-12, >12 line loss in 19,23,11,12 and 11 patients respectively. There was a 1-3, 4-6, 7-9, 10-12, >12 line improvement in 17,9,6,2 and 2 patients respectively.Of all patients, 16% (21)had a VA of >20/200 after 4 years, with a mean VA of 20/73 (range 20/160 to 20/32, median 20/80) including 1 PVR patient and 2 patients with a recurrent neovascularisation. Of the 135 eyes 14 developed PVR and 14 had a recurrent neovascularisation.
Four years after a RPE-choroid graft surgery there is a mean 2.5 line decrease in VA. Nevertheless, at least 16 % of the patients achieved a VA of >20/200 after 4 years. Because the technique of this surgery evolved during the studied years, and still is evolving, we suggest that these data may improve in the future. A controlled trial is needed to establish whether these results are better than natural course or best available treatment.
Clinical Trial: :
This PDF is available to Subscribers Only