Article Text

Download PDFPDF

Autologous translocation of choroid and retinal pigment epithelium in geographic atrophy: long-term functional and anatomical outcome
  1. Albert Caramoy,
  2. Sandra Liakopoulos,
  3. Erica Menrath,
  4. Bernd Kirchhof
  1. Department of Vitreo-Retinal Surgery, Center of Ophthalmology, University of Cologne, Cologne, Germany
  1. Correspondence to Dr Albert Caramoy, Department of Vitreo-Retinal Surgery, Center of Ophthalmology, University of Cologne, Kerpener Str 62, Cologne 50924, Germany; acaramoy{at}yahoo.co.uk

Abstract

Purpose To evaluate the long-term outcome of autologous graft of retinal pigment epithelium (RPE) in patients with geographic atrophy.

Methods Ten patients with progressive geographic atrophy underwent translocation of an autologous graft of RPE, Bruch membrane and choroid. The visual acuity (VA), reading performance, microperimetry, optical coherence tomography (OCT), fundus autofluorescence, fluorescein angiography and indocyanine green angiography were assessed.

Results No recurrence of RPE atrophy was seen. All but one transplant were revascularised. Vascularisation persisted throughout the 3 years' follow-up. Spectral-domain OCT in some cases showed intact photoreceptors or intact outer nuclear and outer plexiform layer overlying the graft. In three cases, the grafts were positioned eccentrically; these patients did not benefit from surgery. The mean VA decreased from 20/80 (range: 20/800 to 20/40) at baseline to 20/200 (range: perception of hand movements to 20/32) at last follow-up. In two patients, VA were stable from 20/50 to 20/32 and 20/40 at the last follow-up, respectively. Postoperative complications included retinal detachment due to proliferative vitreoretinopathy, macular pucker, iritis, branch retinal vein occlusion and secondary ocular hypertension.

Conclusions Some patients benefit for at least 3 years from a functioning RPE-choroid graft. Functional outcome in most patients, however, was limited due to complications and unfavourable patient selection.

  • Age-related macular degeneration
  • geographic atrophy
  • retinal pigment epithelium
  • treatment surgery
  • retina
  • macula
  • choroid

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

View Full Text

Statistics from Altmetric.com

Footnotes

  • Funding Supported in part by the RetinoVit Foundation Cologne.

  • Competing interests None.

  • Patient constent Obtained.

  • Ethics approval Ethics approval was provided by the Ethics Committee, University of Cologne, 50924 Cologne, Germany.

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

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.