Autologous translocation of choroid and retinal pigment epithelium in geographic atrophy: long-term functional and anatomical outcome.
OBJECTIVE
To evaluate the long-term outcome of autologous graft of retinal pigment epithelium (RPE) in patients with geographic atrophy.


METHODS
Ten patients with progressive geographic atrophy underwent translocation of an autologous graft of RPE, Bruch membrane and choroid. The visual acuity (VA), reading performance, microperimetry, optical coherence tomography (OCT), fundus autofluorescence, fluorescein angiography and indocyanine green angiography were assessed.


RESULTS
No recurrence of RPE atrophy was seen. All but one transplant were revascularised. Vascularisation persisted throughout the 3 years' follow-up. Spectral-domain OCT in some cases showed intact photoreceptors or intact outer nuclear and outer plexiform layer overlying the graft. In three cases, the grafts were positioned eccentrically; these patients did not benefit from surgery. The mean VA decreased from 20/80 (range: 20/800 to 20/40) at baseline to 20/200 (range: perception of hand movements to 20/32) at last follow-up. In two patients, VA were stable from 20/50 to 20/32 and 20/40 at the last follow-up, respectively. Postoperative complications included retinal detachment due to proliferative vitreoretinopathy, macular pucker, iritis, branch retinal vein occlusion and secondary ocular hypertension.


CONCLUSIONS
Some patients benefit for at least 3 years from a functioning RPE-choroid graft. Functional outcome in most patients, however, was limited due to complications and unfavourable patient selection.
Caramoy
Albert
A
Department of Vitreo-Retinal Surgery, Center of Ophthalmology, University of Cologne, Kerpener Str 62, Cologne 50924, Germany. acaramoy@yahoo.co.uk
Liakopoulos
Sandra
S
Menrath
Erica
E
Kirchhof
Bernd
B
D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000637:transplantation*; D003941:Diagnostic Techniques, Ophthalmological; D018450:Disease Progression; D005260:Female; D005403:Fixation, Ocular; D005500:Follow-Up Studies; D057092:Geographic Atrophy / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011932:Reading; D012163:Retinal Detachment / Q000209:etiology; D055213:Retinal Pigment Epithelium / Q000473:pathology / Q000637:transplantation*; D016896:Treatment Outcome; D014792:Visual Acuity
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