De Giacinto Chiara, D'Aloisio Rossella, Cirigliano Gabriella, Pastore Marco Rocco, Tognetto Daniele
Eye Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Piazza Ospedale 1, 34129, Trieste, Italy.
Int Ophthalmol. 2019 May;39(5):1147-1150. doi: 10.1007/s10792-018-0904-4. Epub 2018 Mar 27.
To evaluate anatomical and functional outcomes after autologous neurosensory retinal free patch (ANRFP) transplantation for persistent idiopathic full-thickness macular hole (iFTMH).
A 65-year-old woman with persistent macular hole in her right eye after previous 27-gauge pars plana vitrectomy with internal limiting membrane peeling and long-acting gas tamponade underwent ANRFP transplantation. Before surgery, best corrected visual acuity in her right eye was 20/800. Optical coherence tomography (OCT) showed a 715-micron-diameter FTMH. To treat the persistent FTMH, a small autologous neurosensory retinal patch was transplanted and placed inside the macular hole under perfluorocarbon liquids (PFCL). PFCL-air exchange was performed, and long-acting gas tamponade was carried out. Clinical features of the macular area, visual acuity (VA), fundus autofluorescence, microperimetry and OCT were recorded during the 10-month follow-up.
The macular hole appeared successfully closed with retinal patch stable and well plugged into the hole during the whole follow-up. VA improved to 20/100 and microperimetry revealed an increase in mean retinal sensitivity from 14.7 dB at 1 month to 15.6 dB at 10 months postoperatively. OCT showed a well-distinguishable retinal patch into the hole 1 month after surgery and a completely integrated retinal patch between the retinal layers 10 months postoperatively. No intra- and postoperative complications were noticed.
ANRFP transplantation may represent an innovative technique for persistent iFTMH treatment.
评估自体神经感觉视网膜游离补片（ANRFP）移植治疗持续性特发性全层黄斑裂孔（iFTMH）后的解剖和功能结果。
一名65岁女性，此前接受过27G玻璃体切割联合内界膜剥除及长效气体填充术，右眼仍存在持续性黄斑裂孔，接受了ANRFP移植。术前，其右眼最佳矫正视力为20/800。光学相干断层扫描（OCT）显示直径为715微米的全层黄斑裂孔。为治疗持续性全层黄斑裂孔，将一小片自体神经感觉视网膜补片移植并置于全氟碳液体（PFCL）下的黄斑裂孔内。进行了PFCL-空气交换，并实施了长效气体填充。在10个月的随访期间记录黄斑区的临床特征、视力（VA）、眼底自发荧光、微视野检查和OCT结果。
在整个随访期间，黄斑裂孔成功闭合，视网膜补片稳定且良好地嵌入裂孔。视力提高到20/100，微视野检查显示术后1个月平均视网膜敏感度为14.7dB，术后10个月增加到15.6dB。OCT显示术后1个月视网膜补片清晰可辨地嵌入裂孔，术后10个月视网膜补片在视网膜各层之间完全整合。未发现术中及术后并发症。
ANRFP移植可能是治疗持续性iFTMH的一种创新技术。
