Autologous retinal pigment epithelium and choroid translocation in patients with exudative age-related macular degeneration: Short-term follow-up
Autologous retinal pigment epithelium and choroid translocation in patients with exudative age-related macular degeneration: Short-term follow-up
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DOI：
10.1016/s0002-9394(03)00384-2
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发表时间：
2003-10-01
影响因子：
4.2
通讯作者：
Van Den Biesen, PR
中科院分区：
文献类型：
--
作者：
Van Meurs, JC;Van Den Biesen, PR
目的：探讨老年性渗出性黄斑变性患者中央凹下脉络膜新生血管切除后自体视网膜色素上皮细胞和脉络膜移位的可行性。设计：介入性病例系列。方法：对6例患者进行前瞻性评估，随访7 ~ 13个月。所有患者均有大网膜下膜，其中5例有视网膜下出血。术前视力20/400 ~ 20/200。提取新生血管复合体后，从外周中部切出一个由视网膜色素上皮、Bruch膜、绒毛膜毛细血管和脉络膜组成的自体外周全厚斑块，重新定位于黄斑下。功能测试包括糖尿病视网膜病变早期治疗研究视力测试，光学相干断层扫描监视器固定测试，荧光素和吲哚菁绿血管造影，扫描激光检眼镜自身荧光。结果：4例患者视网膜色素上皮斑块扁平，呈棕色毛状。这4例患者均固定在贴片上。术后视力从20/200到20/64不等，其中3例视力提高2线。荧光素和吲哚氰胺血管造影术显示3例患者血运重建。4例患者的视网膜色素上皮可见正常的自身荧光。结论：在脉络膜新血管膜提取后，将带有自体外周视网膜色素上皮的全厚斑块转移到黄斑是可行的，并且可能导致移植存活和功能超过1年。长期随访评估其长期效益是必要的，同时也需要改进手术。(C) 2003年Elsevier Inc.版权所有。
PURPOSE: To evaluate the feasibilty of translocating autologous retinal pigment epithelium cells and choroid after the removal of a subfoveal choroidal neovascular membrane in patients with exudative age-related macular degeneration.DESIGN: Interventional case series.METHODS: This was a prospective evaluation of six patients with a follow-up of 7 to 13 months. All patients had large (> 1 disk diameter) subfoveal choroidal membranes, five with subretinal hemorrhage. Preoperative visual acuity ranged from 20/400 to 20/200. After the extraction of the neovascular complex, an autologous peripheral full,thickness patch of retinal pigment epithelium, Bruch membrane, choriocapillary, and choroid was cut out from the midperiphery and repositioned under the macula. Functional tests included Early Treatment Diabetic Retinopathy Study vision testing, fixation testing on a optical coherence tomography monitor, fluorescein and indocyanine green angiography, and scanning laser ophthalmoscopy autofluorescence.RESULTS: The retinal pigment epithelium patch appeared flat and had a brown furry aspect in four patients. Fixation was on the patch in these four patients. Postoperative vision ranged from 20/200 to 20/64, with a 2,line increase in three patients. Revascularization was visible on fluorescein and indocyanide angiography in three patients examined in this manner. Normal retinal pigment epithelium autofluorescence was present over the patch in four patients.CONCLUSIONS: The translocation of a full,thickness patch with autologous peripheral retinal pigment epithelium to the macula after choroidal neovascular membrane extraction was feasible and may result in a surviving and functioning graft for more than 1 year. Longer follow-up to evaluate its long,term benefit is necessary, as well as refinement of the surgery. (C) 2003 by Elsevier Inc. All rights reserved.