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Autologe RPE-Chorioidea-Translokation bei exsudativer AMD

Eine Falldemonstration 10 konsekutiver Patienten

Autologous RPE-choroid translocation in exudative AMD

A case series of 10 consecutive patients

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Zusammenfassung

Hintergrund

Untersuchung der funktionellen und morphologischen Ergebnisse nach Entfernung einer chorioidalen Neovaskularisationsmembran und autologer RPE-Chorioidea-Translokation bei exsudativer AMD.

Methoden

Die funktionellen und morphologischen Befunde von 10 konsekutiv operierten Patienten (9 exsudative AMD, 1 geographische Atrophie) wurden analysiert. Die Nachbeobachtungszeit betrug im Mittel 16,8 (14–20) Monate. Die funktionelle Evaluation erfolgte mittels MP1-Mikroperimeter.

Ergebnisse

Der präoperative Visus lag zwischen Handbewegung und 0,2, postoperativ zwischen Handbewegung und 0,4. Vier Patienten fixierten auf dem Transplantat. Fünf Patienten zeigten eine retinale Lichtunterschiedsempfindlichkeit (LUE) auf dem Transplantat. Die LUE konnte bei 4 dieser 5 Patienten postoperativ auf konstantem Niveau gehalten werden. Komplikationen: Ablatio retinae (3), PVR (1), CNV-Entwicklung (1).

Schlussfolgerung

Die autologe RPE-Chorioidea-Translokation nach Extraktion einer CNV ist chirurgisch machbar und ein vergleichsweise sicheres Verfahren. Mittels funduskorrelierter Mikroperimetrie lässt sich eine funktionelle Eingliederung des Transplantats aufzeigen. Die retinale LUE auf dem Transplantat kann für mindestens 20 Monate konstant gehalten werden.

Abstract

Background

To evaluate the retinal sensitivity and fixation pattern after removal of choroidal neovascularisation (CNV) and autologous retinal pigment epithelium (RPE)-choroid translocation in patients with exudative age-related macular degeneration (AMD).

Methods

The functional and morphologic results of 10 consecutive patients (nine with exudative AMD, one with geographic atrophy) were analysed. The mean follow-up was 16.8 (14–20) months. Functional evaluation was performed with the MP1 microperimeter.

Results

Preoperative visual acuity ranged from hand motion to 0.2 (decimal), and postoperative visual acuity ranged from hand motion to 0.4. Fixation on the graft was shown in four patients. Microperimetry proved light increment sensitivity over the graft in five patients. Light increment sensitivity could be kept on a constant level in four of these patients. Postoperative complications included retinal detachment (three), proliferative vitreoretinopathy (one), and development of CNV (one).

Conclusion

Autologous RPE-choroid sheet translocation is feasible and comparatively safe. Fixation and light perception on the graft proved to be possible. Light increment sensitivity can be kept on a constant level for at least 20 months.

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  1. Klinik für Ophthalmologie der Universität Schleswig-Holstein, Campus Kiel, Hegewischstraße 2, 24105, Kiel, Deutschland

    F. Treumer, C. Klatt & J. Roider

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  1. F. Treumer
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  2. C. Klatt
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  3. J. Roider
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Correspondence to F. Treumer.

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Treumer, F., Klatt, C. & Roider, J. Autologe RPE-Chorioidea-Translokation bei exsudativer AMD. Ophthalmologe 104, 795–802 (2007). https://doi.org/10.1007/s00347-007-1562-5

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  • DOI: https://doi.org/10.1007/s00347-007-1562-5

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