title: Long-Term Results of Full Macular Translocation for Choroidal Neovascularization in Age-Related Macular Degeneration.
abstract: OBJECTIVE
  To investigate the long-term outcome of full macular translocation (FMT) for neovascular age-related macular degeneration (AMD) and to identify predictive factors.
  
  
  METHODS
  Retrospective, uncontrolled case series.
  
  
  METHODS
  Patients were considered for FMT if they had low vision in the fellow eye and choroidal neovascularization (CNV) along with (1) no response to vascular endothelial growth factor (VEGF) inhibitors, (2) retinal pigment epithelium (RPE) tear, (3) subretinal hemorrhage, (4) foveal scar tissue of recent onset, or (5) CNV before the availability of VEGF inhibitors. From 2004 through 2012, a total of 255 patients underwent FMT. Exclusion criteria were patients younger than 60 years, FMT for disease other than AMD, and a follow-up of less than 12 months.
  
  
  METHODS
  Preoperative, annual, and last distance best-corrected visual acuity (BCVA) were obtained retrospectively from patient files. Complications were recorded using funduscopy, optical coherence tomography, autofluorescence, and angiography.
  
  
  METHODS
  Distance BCVA at 1 year and 5 years after surgery and at last visit compared with preoperative BCVA.
  
  
  RESULTS
  One hundred fifty-eight patients (mean follow-up, 45 months) were included. Median BCVA improved from 0.90 logarithm of the minimum angle of resolution (logMAR) before surgery to 0.70 logMAR 1 year after FMT (2 lines gained; P = 0.000). In a subgroup of 56 patients followed up for 5 years or more, median BCVA improved from 0.95 logMAR before surgery to 0.70 logMAR 1 year after surgery, and remained improved 5 years after FMT with a median BCVA of 0.80 logMAR (1.5 lines gained compared with preoperative BCVA; P = 0.000). The main complications were foveal RPE atrophy (n = 73; 47%) and CNV recurrence (n = 47; 30%). Foveal RPE atrophy (odds ratio [OR], 7.0), CNV recurrence (OR, 2.6), and proliferative vitreoretinopathy (PVR; OR, 17.6) were statistically significant predictors (P < 0.05) for losing 1 line or more at last visit.
  
  
  CONCLUSIONS
  In this study, BCVA was improved up to 5 years after FMT. Foveal RPE atrophy, CNV recurrence, and PVR carried a worse prognosis. In patients who are unlikely to benefit from VEGF inhibitors, FMT can be considered for second eyes with neovascular AMD.
authors.affiliation: Department of Ophthalmology, Sacro Cuore - Don Calabria hospital, Negrar, Verona, Italy. Electronic address: saskia.vanromunde@gmail.com.
authors.forename: Saskia H M
authors.initials: SH
authors.lastname: van Romunde
authors.affiliation: Department of Ophthalmology, Sacro Cuore - Don Calabria hospital, Negrar, Verona, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Polito
authors.affiliation: Department of Ophthalmology, Sacro Cuore - Don Calabria hospital, Negrar, Verona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Bertazzi
authors.affiliation: Department of Computer Science, University of Verona, Verona, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Guerriero
authors.affiliation: Department of Ophthalmology, Sacro Cuore - Don Calabria hospital, Negrar, Verona, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Pertile
mesh_terms: D000369:Aged, 80 and over; D064592:Autografts; D001766:Blindness / Q000534:rehabilitation; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D004396:Coloring Agents; D005260:Female; D005451:Fluorescein Angiography; D005466:Fluorocarbons / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D008266:Macula Lutea / Q000637:transplantation*; D008297:Male; D064847:Multimodal Imaging; D011183:Postoperative Complications; D012189:Retrospective Studies; D012827:Silicone Oils / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D015354:Vision, Low / Q000534:rehabilitation; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*
chemical_list: D004396:Coloring Agents; D005466:Fluorocarbons; D012827:Silicone Oils; D007208:Indocyanine Green