title: Prospective, Randomized Intervention Study Comparing Retinal Pigment Epithelium-Choroid Graft Surgery and Anti-VEGF Therapy in Patients with Exudative Age-Related Macular Degeneration.
abstract: OBJECTIVE
  To investigate whether patients with exudative age-related macular degeneration and a submacular hemorrhage, retinal pigment epithelium (RPE) tear or nonresponders to anti-vascular endothelial growth factor (VEGF) benefit more from a free RPE-choroid graft transplantation surgery than from (continuation of) anti-VEGF treatment.
  
  
  METHODS
  A total of 20 patients were included in this prospective, international, multicenter, randomized intervention study.
  
  
  RESULTS
  The change in the mean number of Early Treatment of Diabetic Retinopathy Study (ETDRS) letters in the graft group 1 year postoperatively was -15 (range -54 to +26), whilst 2 patients experienced a gain of >10 letters. The median preoperative visual acuity (VA) was 0.75 logMAR (range 0.46-2.8), and the mean postoperative VA was 1.48 logMAR (range 0.14-2.8). The change in the mean number of ETDRS letters in the anti-VEGF group was -8 (range -26 to +6); no patients experienced a >10 letter gain. The median preoperative VA was 1.36 logMAR (range 0.58-1.6), and the median postoperative VA was 1.42 logMAR (range 0.44-1.66).
  
  
  CONCLUSIONS
  The included patient group is far too small to draw conclusions. However, both gain and loss of VA may be experienced by patients undergoing either treatment method; more gain might be possible for patients with a graft in the absence of complications.
authors.affiliation: The Rotterdam Eye Hospital, Rotterdam, The Netherlands.
authors.forename: Elsbeth J T
authors.initials: EJ
authors.lastname: van Zeeburg
authors.forename: Matteo G
authors.initials: MG
authors.lastname: Cereda
authors.forename: Sankha
authors.initials: S
authors.lastname: Amarakoon
authors.forename: Jan C
authors.initials: JC
authors.lastname: van Meurs
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D002829:Choroid / Q000637:transplantation; D058449:Intravitreal Injections; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000628:therapy; D012167:Retinal Perforations / Q000628:therapy; D055213:Retinal Pigment Epithelium / Q000637:transplantation; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A; C467484:VEGFA protein, human