EXTENDED REPORT

Autologous peripheral retinal pigment epithelium translocation in patients with subfoveal neovascular membranes

J C van Meurs¹, E ter Averst², L J Hofland², P M van Hagen³, C M Mooy⁴, G S Baarsma¹, R W Kuijpers⁵, T Boks⁶ and P Stalmans⁷

¹ The Rotterdam Eye Hospital, Schiedamsevest 180, 3011 BH, Rotterdam, Netherlands
² Department of Immunology, Erasmus Medical Center, 3011 BH, Rotterdam, Netherlands
³ Department of Internal Medicine, Erasmus Medical Center, 3011 BH, Rotterdam, Netherlands
⁴ Department of Pathology, Erasmus Medical Center, 3011 BH, Rotterdam, Netherlands
⁵ Department of Ophthalmology, Erasmus Medical Center, 3011 BH, Rotterdam, Netherlands
⁶ Sterilization Unit, Erasmus University Medical Center, 3011 BH, Rotterdam, Netherlands
⁷ Department of Ophthalmology, University Hospital, Leuven, Belgium

Correspondence to:
Correspondence to:
Jan C van Meurs, MD
The Rotterdam Eye Hospital, Schiedamsevest 180, 3011 BH, Rotterdam, Netherlands; janvanmeurs{at}cs.com

Aim: To evaluate the possibility of translocating autologous peripheral retinal pigment epithelial (RPE) cells and enhance their adhesion to improve functional outcome after choroidal neovascular membrane extraction in patients with subfoveal neovascular membranes.

Methods: A prospective, non-controlled surgical study in eight consecutive patients operated between February and July 2001 with final data monitoring in July 2002. All patients had mixed subfoveal membranes of 2–4 disc diameters. Functional tests included Snellen vision and central fixation testing. During vitrectomy, after the extraction of the neovascular complex, 8x10⁴–16x10⁴ RPE cells were removed from the periphery and translocated under the macula following the submacular injection of 2 µg of poly-L-lysine to promote adhesion of the cells.

Results: With a follow up ranging from 3 months to 16 months, a pigmented area was seen in the extraction bed of the neovascular membrane in only one patient. Fixation was at the edge of the extraction bed in three patients. Vision remained the same in five patients and deteriorated in three (all with retinal detachment). Retinal detachment due to proliferative vitreoretinopathy occurred in three patients.

Conclusions: The translocation of autologous peripheral RPE cells after membrane extraction was technically possible in a sterile manner, but was associated with a high proliferative vitreoretinopathy rate and in the present series had no measurable positive effect on functional outcome.

Keywords: retinal pigment epithelium; translocation; subfoveal choroidal neovascularisation

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