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Long-term outcomes following full macular translocation surgery in neovascular age-related macular degeneration
  1. Fred K Chen1,2,3,
  2. Praveen J Patel1,2,3,
  3. Gurmit S Uppal1,
  4. Adnan Tufail1,3,
  5. Peter J Coffey2,3,
  6. Lyndon Da Cruz1,2,3
  1. 1Moorfields Eye Hospital, City Road, London, UK
  2. 2University College of London, Institute of Ophthalmology, Bath Street, London, UK
  3. 3NIHR Biomedical Research Centre for Ophthalmology, City Road, London, UK
  1. Correspondence to Dr Fred K Chen, Department of Vitreoretinal Surgery, Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK; fkchen02{at}yahoo.com

Abstract

Background/aims Long-term data of macular translocation for choroidal neovascularisation (CNV) secondary to age-related macular degeneration is lacking. Therefore, we describe the 3-year acuity outcomes.

Methods This is a retrospective, interventional case series consisting of 40 consecutive patients who underwent translocation between 2003 and 2008. Best-corrected visual acuity (BCVA) at the most recent follow-up visit was compared to that of the 1 year and pre-operative visits. Delayed post-operative complications were recorded, as diagnosed by clinical examination, spectral-domain optical coherence tomography, fundus autofluorescence imaging and angiography.

Results The mean (range) follow-up duration was 37.6 months (range 12.4–67.4 months). Median BCVA values were 0.80, 0.70 and 0.78 log(MAR) at the baseline, 1 year and most recent visits (p=0.13). A three-line gain in BCVA was seen in 12 (30%) patients at 1 year and 10 (25%) patients at the last observation. Twenty-seven (68%) patients achieved a BCVA of 6/60 or better and six (15%) patients, 6/12 or better at the final visit. In the subset of the cohort followed for two or more years, 24 of 32 patients (75%) achieved a BCVA of 6/60 at 1 year but six of these (25%) lost two lines of BCVA thereafter due to recurrent CNV, idiopathic macular oedema, macular hole or macular pucker. Recurrent CNV developed in nine patients (23%) within the first 2 years and their final mean VA was 6/30.

Conclusions With close post-operative monitoring and early treatment of delayed complications, 25% of this cohort maintained a three-line gain in acuity at 3 years after macular translocation.

  • Age-related macular degeneration
  • macular translocation surgery
  • optical coherence tomography
  • fundus autofluorescence, choroidal neovascularisation
  • anti-VEGF therapy
  • retina
  • macula
  • neovascularisation
  • degeneration, treatment surgery

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Footnotes

  • Funding This study is funded by the London Project to Cure Blindness and the NIHR Biomedical Research Centre for Ophthalmology.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Moorfields Research Governance Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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