May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Autologous Retinal Pigment Epithelium and Choroid Transplantation With 180 Degrees Peripherical Retinotomy in Patients With Exudative Age-Related Macular Degeneration: Short Term Follow-Sp and Anatomical Outcome
Author Affiliations & Notes
  • M. G. Cereda
    Department of Ophthalmology, Sacro Cuore Hospital of Negrar, Verona, Italy
    Clinical Science Luigi Sacco, Eye Clinic, Luigi Sacco Hospital, University of Milan, Milano, Italy
  • B. Parolini
    Department of Ophthalmology, Sacro Cuore Hospital of Negrar, Verona, Italy
  • G. Staurenghi
    Clinical Science Luigi Sacco, Eye Clinic, Luigi Sacco Hospital, University of Milan, Milano, Italy
  • G. Pertile
    Department of Ophthalmology, Sacro Cuore Hospital of Negrar, Verona, Italy
  • Footnotes
    Commercial Relationships  M.G. Cereda, None; B. Parolini, None; G. Staurenghi, None; G. Pertile, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 4289. doi:
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      M. G. Cereda, B. Parolini, G. Staurenghi, G. Pertile; Autologous Retinal Pigment Epithelium and Choroid Transplantation With 180 Degrees Peripherical Retinotomy in Patients With Exudative Age-Related Macular Degeneration: Short Term Follow-Sp and Anatomical Outcome. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4289.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : to evaluate the feasibility of transplanting autologous retinal pigment epithelium (RPE) cells, choriocapillaris and choroid by a 180° peripheral temporal retinotomy after the removal of a subfoveal choroidal neovascularization (CNV) in patients with age-related macular degeneration.

Methods: : a prospective, observational case series study on 8 patients was developed in order to investigate the topic with a follow-up of 4 to 12 months. All patients had CNV, 3 with vitreous haemorrage, 4 with wide subretinal haemorrhage and 1 with serous-haemorrhagic retinal pigment epithelium detachment. Preoperative visual acuity (VA) ranged from Light Perception to logMar 1.3. After the induced posterior and temporal retinal detachment, the peripheral 180° temporal retinotomy and the extraction of the CNV, an autologous full-thickness patch of choroid, choriocapillaris, Bruch’s membrane and RPE was harvested from the mid-periphery and, after the injection of an heavy liquid, repositioned beneath the macula. All patients underwent a complete ophthalmic examination, Optical Coherence Tomography, Scanning Laser Ophthalmoscopy autofluorescence, dynamic Indocyanine Green Angiography (ICGA) and Fluorescence Angiography.

Results: : the full thickness patch appeared flat, brown and well centered under the fovea in seven patients, one had a wrinkled nasal margin. Post operative vision ranged from LogMar 2.6 to LogMar 0.4; VA increased in 7 patients and remained stable in 1. Revascularization was visible on ICGA in all the patients. In one patient revascularization was absent in the nasal area of the patch after 4 months follow-up. Normal RPE autofluorescence was present over the patch in all the patients. No intra or post operative complications occurred.

Conclusions: : the transplantation of a full thickness patch of choroid, choriocapillaris, Bruch’s membrane and RPE under the macula after a peripheral temporal 180° retinotomy and the extraction of the CNV is feasible and may result in a surviving and functioning graft for more than 6 months. A longer follow-up is necessary to evaluate the efficacy and safety of this treatment.

Keywords: age-related macular degeneration • transplantation • vitreoretinal surgery 
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