A Free Retinal Pigment Epithelium-Choroid Graft in Patients With Exudative Age-Related Macular Degeneration: Results up to 7 Years
A Free Retinal Pigment Epithelium-Choroid Graft in Patients With Exudative Age-Related Macular Degeneration: Results up to 7 Years
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DOI：
10.1016/j.ajo.2011.06.007
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发表时间：
2012-01-01
影响因子：
4.2
通讯作者：
van Meurs, Jan C.
中科院分区：
文献类型：
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作者：
van Zeeburg, Elsbeth J. T.;Maaijwee, Kristel J. M.;van Meurs, Jan C.
目的：报告和分析渗出性年龄相关性黄斑变性（AMD）患者游离自体视网膜色素上皮(RPE)-脉络膜移植易位后的长期最佳矫正视力（BCVA）结果。设计：前瞻性队列研究。方法：环境：机构。研究人群：在2001年10月至2006年2月期间，130例AMD患者（133只眼）接受了rpe -脉络膜移植物移位。所有患者均有中央凹下脉络膜新生血管膜伴或不伴出血和/或RPE撕裂。所有患者都不适合光动力治疗或对光动力治疗无反应，光动力治疗是手术时的标准治疗。观察程序：数据收集包括术前和术后视力测量、眼底摄影、荧光素和吲哚菁绿血管造影、显微镜验光。主要观察指标：术后BCVA。结果：术前BCVA平均值为20/250。术后4年，15%的眼睛BCVA为>= 20/200,5%的眼睛BCVA为>= 20/40。1例患者BCVA为20/32，术后维持7年。并发症包括增生性玻璃体视网膜病变（n = 13），复发性新生血管（n = 13）和低视（n = 2）。结论：rpe -脉络膜移植术后可维持黄斑功能长达7年，并发症和复发率相对较低。视网膜敏感性、BCVA数据和移植物上的固定表明，移植物，而不是简单地去除黄斑下出血和/或脉络膜新生血管膜，是黄斑功能保存的原因。对于不能接受其他标准治疗的AMD患者，这种手术可能是另一种选择。[J]中华眼科杂志，2012;33(3):1190 - 1190。(C) 2012年Elsevier Inc.版权所有。)
PURPOSE: To report and analyze long-term best-corrected visual acuity (BCVA) outcomes following a free autologous retinal pigment epithelium (RPE)-choroid graft translocation in patients with exudative age-related macular degeneration (AMD).DESIGN: Prospective cohort study.METHODS: SETTING: Institutional. STUDY POPULATION: One hundred and thirty consecutive patients (133 eyes) with AMD underwent RPE-choroid graft translocation between October 2001 and February 2006. All patients had a subfoveal choroidal neovascular membrane with or without hemorrhage and/or an RPE tear. All were either ineligible for or nonresponsive to photodynamic therapy, the standard treatment at the time of surgery. OBSERVATION PROCEDURES: Data collection included preoperative and postoperative visual acuity measurements, fundus photography, fluorescein and indocyanine green angiography, and microperimetry. MAIN OUTCOME MEASURES: Postoperative BCVA.RESULTS: The mean preoperative BCVA was 20/250. Four years after surgery, 15% of the eyes had a BCVA of >20/200, and 5% had a BCVA of >= 20/40. One patient achieved a BCVA of 20/32, which was maintained at 7 years after surgery. Complications consisted of proliferative vitreoretinopathy (n = 13), recurrent neovascularization (n = 13), and hypotony (n = 2).CONCLUSIONS: RPE-choroid graft transplantation may maintain macular function for up to 7 years after surgery, with relatively low complication and recurrence rates. Retinal sensitivity, BCVA data, and fixation on the graft suggest that the graft, rather than simply the removal of submacular hemorrhage and/or choroidal neovascular membrane, was responsible for the preservation of macular function. This surgery may be an alternative for patients with AMD who cannot undergo other standard treatment. (Am J Ophthalmol 2012;153:120-127. (C) 2012 by Elsevier Inc. All rights reserved.)