Purchase this article with an account.
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.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
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.
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.
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.
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.
This PDF is available to Subscribers Only