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Maurizio Mete, Grazia Pertile, Antonio Peroglio Deiro, Alessandro Alfano, Mauro Sartore, Antonio Polito, Massimo Guerriero; New Insights into the Development and Progression of Geographic Atrophy after Full Thickness Autologous Choroidal Graft. Invest. Ophthalmol. Vis. Sci. 2018;59(9):2431.
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© ARVO (1962-2015); The Authors (2016-present)
To study if the continuity between native- and transplanted retinal pigment epithelium (RPE) represents a protective factor against the progression of atrophy after autologous full thickness choroidal graft in exudative age-related macular degeneration (AMD). In addition, the changes in fundus autofluorescence (FAF) in the areas of overlapping and non- overlapping RPE were explored.
A total of 19 patients who underwent an autologous choroidal graft at our hospital between 2007 and 2013 , met the inclusion criteria, and were included in this study. The first post-operative reliable FAF image was selected and divided into sectors based on the characteristics of the RPE at the edge of the graft. The areas were categorized into three groups: RPE overlapping, RPE non-overlapping and not classifiable. The area of RPE atrophy, inside and outside the graft, was measured for each sector at baseline, one, three and five years. FAF pattern outside the graft was evaluated for every sector at baseline and during the follow-up.
Trend-analysis showed that atrophy progression outside the graft was statistically significant in the areas of non-overlapping between native and transplanted RPE (P<0.0001), but it was not in the areas of overlapping (P<0.058). Inside the graft, both groups show a statistically significant increase of atrophy over time. Nevertheless, the non-overlapping group exhibits a more rapid progression. The non-overlapping group developed more severe increased FAF patterns compared with the overlapping group. The difference was statistically significant at any time point.
RPE continuity after autologous choroidal graft seems to be a protective factor against the progression of atrophy. In contrast, any area of damaged or absent RPE and choriocapillaris tends to enlarge over time. This may suggest that transplantation of an RPE sheet is more likely to be effective than an RPE cells’ suspension.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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