Veckeneer M, Augustinus C, Feron E, Schauwvlieghe P-P, Ruys J, Cosemans I, Van Meurs J
Department of Ophthalmology, ZNA Middelheim, Antwerp, Belgium.
Rotterdam Eye Hospital, Rotterdam, The Netherlands.
Eye (Lond). 2017 Sep;31(9):1274-1283. doi: 10.1038/eye.2017.137. Epub 2017 Jul 21.
PurposeThe purpose of this study is to investigate the reperfusion of translocated retinal pigment epithelium (RPE)-choroid graft in the treatment of patients with neovascular age-related macular degeneration (nAMD), using OCT angiography (OCTA), a novel non-invasive, high-resolution imaging modality.Patients and methodsEighteen eyes of 18 consecutive patients suffering from complicated nAMD underwent RPE-choroid patch graft translocation surgery using a peripheral retinotomy and flap-over technique. We analyzed functional and anatomical outcome using visual acuity, Spectral Domain OCT and OCTA.ResultsWith a mean follow-up of 11 months, out of 18 patients, 15 gained vision, 1 remained stable, and 2 lost vision. Overall, the visual acuity improved with a mean of 30 letters. Perfusion of the graft tissue was confirmed in all patients. Two patients developed signs of a recurrent neovascular membrane during follow-up. No cases of proliferative vitreoretinopathy occurred in this series.ConclusionsOCTA images show signs of perfusion in all grafts. Encouraging functional results and low risk of severe complications suggest that RPE-choroid graft translocation is a valid option in patients with complicated nAMD.
目的
本研究旨在使用光学相干断层扫描血管造影(OCTA)这一新型非侵入性高分辨率成像方式,调查移植的视网膜色素上皮(RPE)-脉络膜移植物在治疗新生血管性年龄相关性黄斑变性(nAMD)患者中的再灌注情况。
患者与方法
18例连续患有复杂性nAMD的患者的18只眼,采用周边视网膜切开术和翻转瓣技术进行了RPE-脉络膜补片移植移位手术。我们使用视力、光谱域光学相干断层扫描(SD-OCT)和OCTA分析了功能和解剖学结果。
结果
平均随访11个月,18例患者中,15例视力提高,1例稳定,2例视力下降。总体而言,视力平均提高了30个字母。所有患者的移植物组织均证实有灌注。2例患者在随访期间出现新生血管膜复发迹象。本系列未发生增殖性玻璃体视网膜病变病例。
结论
OCTA图像显示所有移植物均有灌注迹象。令人鼓舞的功能结果和严重并发症的低风险表明,RPE-脉络膜移植物移位术是复杂性nAMD患者的一种有效选择。