Reduction of iatrogenic RPE lesions in AMD patients: evidence for wound healing?
OBJECTIVE
Our purpose was to study retinal pigment epithelium (RPE) wound healing in patients with age-related macular degeneration (AMD).


METHODS
Abrasive debridement of nasal RPE was performed with a metal cannula during pars plana vitrectomy for foveal choroidal neovascularization (CNV) membrane excision combined with simultaneous autologous RPE transplantation. Fundus autofluorescence, fluorescein angiography images, and red-free pictures were taken initially within 1-2 weeks postoperatively, subsequently in 2-week intervals until 3 months, monthly until 6 months, and every 3 months thereafter. The borders of these lesions were measured; areas were calculated and compared using ArchiCad Software. Fourteen eyes of 14 patients suffering from AMD were included (nine women and four men, mean age 75.6 years +/-6.6 years).


RESULTS
Six of 14 (42.9 %) patients showed a reduction of the RPE debrided area. The size of these lesions reduced 5.6-20% within 2 postoperative months compared with their size at first examination (from a mean of 13.7 mm2 +/- 7.2 at baseline to a mean of 12.8 mm2 +/- 6.7 at 2 months postoperatively). No further reduction of the lesions was seen after the 2 months. In eight cases, borders of the RPE debrided areas stayed stable during observation time.


CONCLUSIONS
Wound healing of abrasively debrided RPE monolayer defects in patients with AMD occurs to a certain extent in nearly half of the cases. This process seems to stop after 2 months.
Rabenlehner
Doris
D
The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Lasersurgery, Vienna, Austria. doris.rabenlehner@mediatrain.at
Stanzel
Boris V
BV
Krebs
Ilse
I
Binder
Susanne
S
Goll
Alexandra
A
D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D003646:Debridement; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control*; D008268:Macular Degeneration / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010857:Pigment Epithelium of Eye / Q000502:physiology* / Q000637:transplantation; D014821:Vitrectomy; D014945:Wound Healing
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