Long-term results after limited macular translocation surgery for wet age-related macular degeneration.
Long-term results after limited macular translocation surgery for wet age-related macular degeneration.
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DOI：
10.1371/journal.pone.0177241
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Terasaki H
中科院分区：
文献类型：
--
作者：
Oshima H;Iwase T;Ishikawa K;Yamamoto K;Terasaki H
目的：评价在湿性年龄相关性黄斑变性（AMD）和中心凹下脉络膜新生血管（CNV）患者中采用放射状脉络膜巩膜外折的有限性黄斑移位（LMT）手术的长期结果。此外，确定与最终最佳矫正视力（BCVA）相关的因素。回顾了20例（65.2±9.8岁）连续患者的20只眼的病历，这些患者接受了LMT治疗湿性AMD，并随访了至少5年。记录手术结果，包括最佳矫正视力、中心凹移位程度和并发症。LMT后平均中心凹位移为1332 ± 393 μm。其中16只眼行CNV切除，4只眼行光凝。术前平均VA为0.83 ± 0.33 logMAR单位，术后1年显著改善至0.59 ± 0.37 logMAR单位（P = 0.015）。最终检查时，BCVA维持在0.59 ± 0.41 logMAR单位。最终BCVA与术后1年BCVA呈显著相关（r = 0.83，P<0.001）。多元线性回归分析显示，最终BCVA与术后1年BCVA（P<0.001）、CNV复发（P = 0.001）和年龄（P = 0.022）显著相关。LMT治疗1年后BCVA明显改善，改善的BCVA可持续至少5年。这些结果表明，在中央凹处的感觉视网膜的受损功能可以在移位后的新RPE上恢复至少5年。在新的RPE上长时间维持良好视网膜功能的能力对于未来CNV的治疗如RPE细胞和干细胞的移植是重要的。
To evaluate the long-term results of limited macular translocation (LMT) surgery with radial chorioscleral outfolding in patients with wet age-related macular degeneration (AMD) and subfoveal choroidal neovascularization (CNV). In addition, to identify the factors associated with the final best-corrected visual acuity (BCVA). The medical records of 20 eyes of 20 consecutive patients (65.2±9.8 years) who had undergone LMT for the treatment of wet AMD and were followed for at least 5 years, were reviewed. The surgical outcomes including the BCVA, degree of foveal displacement, and complications were recorded. The mean foveal displacement was 1332 ± 393 μm after the LMT. The CNV was removed in 16 eyes and photocoagulated in 4 eyes. The mean preoperative VA was 0.83 ± 0.33 logMAR units which significantly improved to 0.59 ± 0.37 logMAR units at 1 year after the surgery (P = 0.015). This BCVA was maintained at 0.59 ± 0.41 logMAR units on the final examination. The final BCVA was significantly correlated with that at 1 year after the surgery (r = 0.83, P<0.001). Multiple linear regression analysis showed that the final BCVA was significantly correlated with the BCVA at 1 year after the surgery (P<0.001), a recurrence of a CNV (P = 0.001), and the age (P = 0.022). LMT improves the BCVA significantly at 1 year, and the improved BCVA lasted for at least 5 years. These results indicate that the impaired function of the sensory retina at the fovea can recover on the new RPE after the displacement for at least 5 years. The ability to maintain good retinal function on the new RPE for a long period is important for future treatments of CNVs such as the transplantation of RPE cells and stem cells.