title: Early perfusion of a free RPE-choroid graft in patients with exudative macular degeneration can be imaged with spectral domain-OCT.
abstract: OBJECTIVE
  To study early flow and revascularization in a free, autologous, retinal pigment epithelium (RPE)-choroid graft.
  
  
  METHODS
  This prospective cohort study used spectral domain-optical coherence tomography (SD-OCT) after RPE-choroid graft surgery in 12 patients. This SD-OCT was combined with fluorescein angiography (FA) and indocyanine green angiography (ICGA) in 5 patients.
  
  
  RESULTS
  SD-OCT revealed that vessel diameter, number of vessels, and graft thickness increased in 10 of 12 patients, starting between 3 and 10 days after surgery. A subsequent decrease in thickness was found in all 10 patients, beginning as early as 8 days after surgery. Initially, the graft vessels were optically clearer than the underlying choroidal recipient vessels. Between 8 and 30 days after surgery, the optically clear vessels became gray, similar to the recipient choroid. FA and ICGA revealed perfusion in 4 of 5 patients between postoperative days 6 and 15. Between postoperative days 12 and 60, the entire choroidal structure of the graft was visible on ICGA. CONCLUSIONS; These data suggest that enlargement of vessel diameter, increase in the number of choroidal vessels, and graft thickening visualized by SD-OCT correspond with the ingrowth of afferent vessels, as demonstrated by ICGA. The subsequent establishment of efferent vessels results in flow, imaged as a change in color of the graft's vessels from optically clear to gray, graft thinning on SD-OCT, and complete revascularization on ICGA. SD-OCT, a noninvasive examination, can be used to demonstrate early graft perfusion in patients (trialregister.nl/trialreg/admin/rctview.asp number, NTR1768).
authors.affiliation: The Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands. elsbethvanzeeburg@hotmail.com
authors.forename: Elsbeth J T
authors.initials: EJ
authors.lastname: van Zeeburg
authors.forename: Matteo G
authors.initials: MG
authors.lastname: Cereda
authors.forename: Josine
authors.initials: J
authors.lastname: van der Schoot
authors.forename: Grazia
authors.initials: G
authors.lastname: Pertile
authors.forename: Jan C
authors.initials: JC
authors.lastname: van Meurs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002829:Choroid / Q000637:transplantation*; D004396:Coloring Agents; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008268:Macular Degeneration / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055213:Retinal Pigment Epithelium / Q000637:transplantation*; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green