Department of Vitreo-Retinal Surgery, Center of Ophthalmology, University of Cologne, Cologne, Germany.
Acta Ophthalmol. 2011 Sep;89(6):e490-5. doi: 10.1111/j.1755-3768.2011.02143.x. Epub 2011 Mar 17.
To evaluate the functional and anatomical outcome of patients undergoing autologous transplant of retinal pigment epithelium (RPE) and choroid after RPE tear secondary to age-related macular degeneration (AMD).
Data from nine eyes of nine patients were analysed retrospectively. Examinations included fluorescein and indocyanine green angiography, fundus autofluorescence imaging, optical coherence tomography, microperimetry and determination of visual acuity (far and reading ability). Data regarding intraoperative and postoperative complications were recorded. Mean follow-up time was 18 months (range 4 months to 5 years).
After surgery, far visual acuity improved or remained stable (±3 lines) in three of nine eyes and for the near visual acuity in three of nine eyes. Visual acuity decreased postoperatively at the last follow-up in four eyes mainly because of postoperative complications, i.e. retinal detachment due to proliferative vitreoretinopathy, retinal artery occlusion, pucker and fibrosis of the graft. In one case, retinal stimuli were restored over the scotoma as seen in microperimetry.
Autologous transplant of RPE and choroid is a therapy option for RPE tears. Retinal stimuli can be restored in selected cases. Numerous intra- and postoperative complications compromise the functional prognosis and outcome.
评估因年龄相关性黄斑变性(AMD)导致的 RPE 撕裂后进行自体 RPE 和脉络膜移植的患者的功能和解剖结果。
回顾性分析了 9 名患者 9 只眼的数据。检查包括荧光素和吲哚青绿血管造影、眼底自发荧光成像、光学相干断层扫描、微视野和视力(远和阅读能力)测定。记录了术中及术后并发症的数据。平均随访时间为 18 个月(4 个月至 5 年)。
术后,9 只眼中有 3 只眼的远视力提高或保持稳定(±3 行),9 只眼中有 3 只眼的近视力提高或保持稳定。在最后一次随访时,4 只眼的视力术后下降,主要是由于术后并发症,即由于增生性玻璃体视网膜病变、视网膜动脉阻塞、移植片皱缩和纤维化导致的视网膜脱离。在 1 例病例中,微视野观察到在暗点上恢复了视网膜刺激。
自体 RPE 和脉络膜移植是治疗 RPE 撕裂的一种选择。在某些病例中可以恢复视网膜刺激。许多术中及术后并发症会影响功能预后和结果。