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Surgery for CNV and autologous choroidal RPE patch transplantation: exposing the submacular space

  • Matteo Giuseppe CeredaEmail author
  • Barbara Parolini
  • Elisa Bellesini
  • Grazia Pertile
Retinal Disorders

Abstract

Background

To evaluate the feasibility of transplanting a full-thickness patch of choroid, choriocapillaries, Bruch’s membrane and RPE (RPE-choroid FTAP) from the peripheral to the subfoveal area of the same eye, after performing a 180° peripheral retinotomy and removing subfoveal choroidal neovascularization. Thereafter, to study the surgical complications, anatomical outcome and patch perfusion during follow-up.

Methods

A retrospective case series of 13 eyes of 13 consecutive patients with a follow-up of 4 to 20 months. All patients suffered from advanced subfoveal choroidal neovascularization and were non-responders to standard care. After performing a complete vitrectomy, a 180° peripheral temporal retinotomy and the removal of subfoveal neovascularization, a FTAP of choroid, choriocapillaris, Bruch’s membrane and the RPE were isolated from the mid periphery of the uveal bed, transpositioned under the fovea and covered with the retina. Patients received a complete ophthalmic examination, fluorescein angiography (FA), indocyanin green angiography (ICGA) and optical coherence tomography (OCT) during follow-up.

Results

An FTAP could be harvested in every eye and transplanted under the fovea. No intraoperative complications occurred. The FTAP was recognizable at FA, ICGA and OCT at each time point, up to 20 months postoperatively. Perfusion of the choroidal bed were observed into the FTAP during follow-up, from one week after surgery.

Conclusion

The creation of an FTAP through a 180° peripheral retinotomy is feasible and safe. The FTAP is vital and perfused. Further studies are needed to collect more data.

Keywords

RPE translocation OCT Fluorescein angiography Indocyanin angiography AMD CNV removal 

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Matteo Giuseppe Cereda
    • 1
    • 2
    Email author
  • Barbara Parolini
    • 1
  • Elisa Bellesini
    • 1
  • Grazia Pertile
    • 1
  1. 1.Department of OphthalmologyOspedale Sacro CuoreNegrarItaly
  2. 2.Via Don SempreboniNegrarItaly

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