Sacrocuore Hospital, Negrar, Verona, Italy.
Department Computer Science, University of Verona, Verona, Italy.
Acta Ophthalmol. 2019 Mar;97(2):e283-e289. doi: 10.1111/aos.13880. Epub 2018 Oct 3.
To describe the change in the retinal morphology after full macular translocation (FMT) for exudative age-related macular degeneration (AMD) and identify predictive factors for the visual outcome.
All patients who underwent FMT from December 2008 through July 2013 were selected. Exclusion criteria were FMT for other disease than AMD, age <60 years, <12 months of follow-up or no available images. Spectral domain optical coherence tomography, fundus autofluorescence, fluorangiography and indocyanine green angiography were evaluated.
In total, 51 patients were included with a mean follow-up of 30 months. The presence of the external limiting membrane (ELM) was a significant predictor for a favourable visual outcome 1 year after FMT (OR = -0.30). Other significant predictive factors were the absence of intraretinal fluid (OR = 0.28) and the mixed choroidal neovascularization type (OR = -0.47), whereas nonresponders (OR = 0.41) and fibrotic lesions (OR = 0.35) were less likely to have a good visual function after surgery.
Full macular translocation (FMT), that permits to relocate the diseased macula onto an area of unaffected retinal pigment epithelial and choroid, can restore the anatomy and visual function in some patients with AMD when the outer retina layers are not irreversibly damaged. The presence of the ELM seems to be the most reliable factor in predicting the functional outcome.
描述湿性年龄相关性黄斑变性（AMD）患者行全黄斑转位术（FMT）后的视网膜形态变化，并确定其视力结果的预测因素。
选择 2008 年 12 月至 2013 年 7 月期间行 FMT 的所有患者。排除标准为 FMT 治疗其他疾病而非 AMD、年龄<60 岁、随访时间<12 个月或无可用图像。评估了频域光学相干断层扫描、眼底自发荧光、荧光血管造影和吲哚青绿血管造影。
共纳入 51 例患者，平均随访 30 个月。术后 1 年 ELM 的存在是视力结果良好的显著预测因素（OR=-0.30）。其他显著的预测因素包括无视网膜内液（OR=0.28）和混合脉络膜新生血管型（OR=-0.47），而非应答者（OR=0.41）和纤维化病变（OR=0.35）术后视力功能恢复良好的可能性较小。
FMT 可将病变黄斑转位到未受影响的视网膜色素上皮和脉络膜区域，在某些外层视网膜层未不可逆损伤的 AMD 患者中，可恢复解剖和视力功能。ELM 的存在似乎是预测功能结果的最可靠因素。
