Original ArticleLong-term Results of Submacular Surgery Combined with Macular Translocation of the Retinal Pigment Epithelium in Neovascular Age-Related Macular Degeneration
Section snippets
Materials and Methods
Of the 9 original trial patients, 3 could not be contacted (one of whom had moved abroad), and 1 was known to be deceased. Two of the 6 contacted declined further investigation: one because she was terminally ill with cancer and the other because he was immobile as a result of a cerebrovascular accident. The 4 remaining patients agreed to return to the eye hospital for review and repeat investigations. These corresponded to male patients 2, 3, 4, and 6 from the original study and are
Results
All 4 patients offered positive comments about having been in the original trial, and none had suffered a recurrence of CNVs in either eye during the 5 to 6 years of follow-up. Two patients (3 and 6) felt their vision had improved as a result of surgery, patient 2 felt no change, and patient 4 felt his vision had declined further. Patient 4 also had underlying unilateral glaucoma, which had advanced significantly over the subsequent 5 years after surgery, and his left optic disc showed
Discussion
The 5- to 6-year follow-up of 4 of 9 AMD patients who originally underwent removal of CNVs with translocation of extrafoveal RPE across the macula revealed a further decline in VA and loss of foveal fixation. The decline occurred after the original description of the technique at the 2-year follow-up. Late changes in autofluorescence were also noted: increasing over the graft donor site and virtually disappearing over the graft itself.
Although the long-term results of this pilot study are
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2016, Survey of OphthalmologyCitation Excerpt :Visual improvement is, however, less than with macular translocation.21,138 This might be explained by incomplete revascularization of the RPE-choroid graft and by a delayed apoptosis of photoreceptors induced by surgical manipulation in the subretinal space.90 Although this technique cannot presently be considered a standard treatment for SMH, improvements in microsurgical techniques and instrumentation may yet lead to less traumatic CNV removal and insertion of the RPE-choroid graft, such that further, carefully monitored studies may be justified.
Human embryonic stem cell-derived retinal pigment epithelium in patients with age-related macular degeneration and Stargardt's macular dystrophy: Follow-up of two open-label phase 1/2 studies
2015, The LancetCitation Excerpt :Nonetheless, the suggestion of improvement in treated eyes, taken with the absence of significant vision loss in treated eyes and lack of improvement in untreated control eyes, is a promising finding that merits further investigation. Although the transplantation of sheets and suspensions of primary retinal pigment epithelium cells has been previously attempted,9–16 such sources are extremely few and variable with respect to quality and expansion capacity.34 Previous studies might have failed because in most cases the transplants were placed in the centre of large atrophic zones with presumably atrophic choriocapillaris, Bruch's membrane, and outer retinal (photoreceptor) anatomy.
Retinoid Processing in Induced Pluripotent Stem Cell-Derived Retinal Pigment Epithelium Cultures
2015, Progress in Molecular Biology and Translational Science
Manuscript no. 2005-313.
Supported by the June Sutor Research Fellowship, London, United Kingdom; Frances Renée Hock Fund, London, United Kingdom; and Moorfields Trustees, London, United Kingdom.
The authors have no proprietary or financial interest related to the article or any technique described herein.