Autologous translocation of the choroid and RPE in age-related macular degeneration: 1-year follow-up in 30 patients and recommendations for patient selection.
OBJECTIVE
To evaluate the long-term (1 year) functional and anatomical outcome of autologous translocation of peripheral choroid and retinal pigment epithelium (RPE) in 30 patients with age-related macular degeneration (AMD).


METHODS
After the extraction of the neovascular complex, an autologous peripheral full-thickness graft of RPE and choroid was positioned under the macula. Functional tests included ETDRS vision, reading (Radner test), and microperimetry (scanning laser ophthalmoscope). Fluorescein, indocyanine green angiography, and autofluorescence were monitored.


RESULTS
Preoperative visual acuity ranged from 20/40 to 20/800 (0.3-1.6 log MAR). Vision ranged from 20/25 to LP (0.1-2.1 log MAR) 1 year after surgery, with stabilization in six eyes, an increase in five eyes, and a decrease in 19 eyes. Deterioration mostly occurred within the first 3 months after surgery. In patients who demonstrated vascularization of the graft after 3 months, this persisted up to 12 months as did fixation when initially stable. Autofluorescence decreased significantly from 6 to 12 months postoperatively. Eleven cases showed a recurrence of choroidal neovascularization (CNV) within this period.


CONCLUSIONS
Patch translocation results in a viable graft. There is no evidence of graft failure within a 1-year follow-up. Nevertheless, there is risk for late CNV formation originating from the edges of the excision side of the CNV and growing peripheral to the graft.
Heussen
F M A
FM
Department of Vitreoretinal Surgery, Center of Ophthalmology, University of Cologne, Cologne, Germany.
Fawzy
N F
NF
Joeres
S
S
Lux
A
A
Maaijwee
K
K
Meurs
J Cv
JC
Kirchhof
B
B
Joussen
A M
AM
D000368:Aged; D002829:Choroid / Q000503:physiopathology / Q000637:transplantation*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D019721:Ophthalmoscopes; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology; D055213:Retinal Pigment Epithelium / Q000503:physiopathology / Q000637:transplantation*; D014182:Transplantation, Autologous; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests / Q000379:methods
D004396:Coloring Agents; D007208:Indocyanine Green