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经周边视网膜切开的视网膜色素上皮脉络膜移植物治疗渗出性年龄相关性黄斑变性:长期结果。

RETINAL PIGMENT EPITHELIUM-CHOROID GRAFT WITH A PERIPHERAL RETINOTOMY FOR EXUDATIVE AGE-RELATED MACULAR DEGENERATION: Long-Term Outcome.

机构信息

Sacro Cuore Hospital, Department of Ophthalmology, Negrar (Verona), Italy.

Department Computer Science, University of Verona, Verona, Italy.

出版信息

Retina. 2019 Feb;39(2):288-295. doi: 10.1097/IAE.0000000000001945.

Abstract

PURPOSE

To investigate the long-term outcome of autologous retinal pigment epithelium -choroid transplantation with a peripheral retinotomy for exudative age-related macular degeneration.

METHODS

In a retrospective study, we selected all patients who underwent a retinal pigment epithelium-choroid transplantation from 2007 through 2013. Exclusion criteria were age <60 years, <12 months of follow-up, and retinal pigment epithelium-choroid graft for other diseases than age-related macular degeneration. The main outcome measure was best-corrected visual acuity converted into logarithm of the minimum angle of resolution.

RESULTS

In this study, 81 patients were included with a mean follow-up of 38 months (SD = 19). Median best-corrected visual acuity improved from 1.30 logarithm of the minimum angle of resolution (20/400 Snellen) to 0.90 logarithm of the minimum angle of resolution (20/160 Snellen) 1 year after surgery (P < 0.001). A ≥3-line gain was achieved in 43 patients (53%) 1 year postoperatively and 37 patients (46%) preserved their visual gain until last visit. Of 4 patients with an 8-year follow-up, 3 patients had a ≥6-line gain at last visit. Severe complications were submacular hemorrhage (n = 8, 10%), macular hole (n = 6, 7%), and proliferative vitreoretinopathy (n = 3, 4%).

CONCLUSION

Best-corrected visual acuity improved significantly after retinal pigment epithelium-choroid transplantation in patients with age-related macular degeneration and preservation of visual gain was possible in the long term.

摘要

目的

研究经周边视网膜切开术行自体视网膜色素上皮 -脉络膜移植治疗渗出性年龄相关性黄斑变性的长期疗效。

方法

在一项回顾性研究中,我们选择了 2007 年至 2013 年间所有接受视网膜色素上皮 -脉络膜移植的患者。排除标准为年龄 <60 岁、随访时间 <12 个月以及因年龄相关性黄斑变性以外的疾病而行视网膜色素上皮 -脉络膜移植。主要观察指标为最佳矫正视力,换算为最小分辨角对数。

结果

本研究共纳入 81 例患者,平均随访 38 个月(标准差 = 19)。术后 1 年,中位最佳矫正视力从 1.30 最小分辨角对数(20/400 Snellen)提高至 0.90 最小分辨角对数(20/160 Snellen)(P < 0.001)。术后 1 年,43 例(53%)患者视力提高 ≥3 行,37 例(46%)患者视力保持稳定。4 例患者随访 8 年,末次随访时 3 例患者视力提高 ≥6 行。严重并发症包括黄斑下出血(n = 8,10%)、黄斑裂孔(n = 6,7%)和增生性玻璃体视网膜病变(n = 3,4%)。

结论

年龄相关性黄斑变性患者行视网膜色素上皮 -脉络膜移植后最佳矫正视力显著提高,且长期视力保持稳定。

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