The Translocation of Autologous Retinal Pigment Epithelium and Choroid Translocation in Patients With Exudative Macular Degeneration: Analysis of Visual Results

Abstract

Abstract: : Purpose:To evaluate the visual outcome after one–year of autologous midperipheral retinal pigment epithelium translocation following the removal of a subfoveal choroidal neovascularization in patients with exudative age–related macular degeneration (ARMD) and to identify preoperative factors that correlate with vision improvement. Methods:In 41 consecutive patients best corrected ETDRS was measured preoperatively and at one–year postoperatively and converted to LogMAR . The correlations between preop vision, type and size of the neovascular membrane, presence and size of subretinal hemorrhage and duration of visual loss and either a vision of 20/80 or more or an 3 ETDRS lines increase were tested with multivariate analysis. Results:Mean visual acuity change was 0.034 LogMAR, a decrease of 0.3 ETDRS line. 63 % of patients lost less than 3 ETDRS lines. Preoperatively 1 patient's vision was 20/80, whereas 7 patients' vision was 20/80 or better after 1 year. Multivariate analysis failed to reveal a statistically significant relation between the preoperative variables and visual outcome. Postoperative complications included retinal detachment with PVR in 2 patients, suprachoroidal hemorrhage in 1 patient and recurrent choroidal neovascularization in 6 patients. Conclusions: An autologous RPE translocation results in moderate visual loss in the majority of patients as well as in a vision of 20/80 or more in 18 %; we were unable to identify preoperative factors for better patient selection, possibly due to too many other variables, such as peroperative ones (because of the current lack of a standardized surgical technique) and postoperative complications.

Keywords: retinal pigment epithelium • transplantation • age-related macular degeneration