title: Autologous transplantation of simple retinal pigment epithelium sheet for massive submacular hemorrhage associated with pigment epithelium detachment.
abstract: OBJECTIVE
  To evaluate the long-term outcome of autologous simple RPE sheet transplantation in patients with simultaneous massive submacular hemorrhage and pigment epithelium detachment (PED).
  
  
  METHODS
  Fourteen patients with 10 occult AMD eyes and 4 PCV eyes underwent a surgical procedure including a 180° peripheral temporal retinotomy, choroidal neovascular membrane (CNVM) excision, and transplantation of an autologous simple RPE sheet developed from the PED region outside the CNVM lesion. Best-corrected visual acuity, multifocal ERG, and microperimetry were recorded to evaluate macular function. Optical coherence tomography, fundus fluorescein angiography, and an RPE autofluorescence test were performed to observe the status of the transplanted simple RPE sheet.
  
  
  RESULTS
  Mean follow-up duration was 24 ± 6 months. Mean ETDRS score increased from 14.0 ± 23.4 preoperatively to 31.9 ± 23.8 at 18 months postoperatively (P < 0.05). Of 14 eyes, 5 (36%) presented with central fixation postoperatively, whereas only 3 (21%) eyes presented with central fixation preoperatively. Ten grafts (71%) showed normal RPE color. Postoperative complications included one (7%) retinal detachment due to proliferative vitreoretinopathy and one (7%) delayed recurrent submacular hemorrhage.
  
  
  CONCLUSIONS
  Transplantation of an autologous simple RPE sheet for eyes with massive submacular hemorrhage associated with PED was achieved with a simplified surgical procedure, resulting in increased postoperative visual acuity.
authors.affiliation: Department Ophthalmology, Peking University Third Hospital, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Han
authors.forename: Zhizhong
authors.initials: Z
authors.lastname: Ma
authors.forename: Changguan
authors.initials: C
authors.lastname: Wang
authors.forename: Hongliang
authors.initials: H
authors.lastname: Dou
authors.forename: Yuntao
authors.initials: Y
authors.lastname: Hu
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Feng
authors.forename: Yimin
authors.initials: Y
authors.lastname: Xu
authors.forename: Zhengqin
authors.initials: Z
authors.lastname: Yin
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012166:Retinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D055213:Retinal Pigment Epithelium / Q000637:transplantation*; D014182:Transplantation, Autologous; D014792:Visual Acuity
keywords: age-related macular degeneration; massive submacular hemorrhage; pigment epithelium detachment; polypoidal choroidal vasculopathy; simple RPE sheet transplantation; sub-RPE hemorrhage