visual acuity of 20/32, 13.5 years after a retinal pigment epithelium and choroid graft transplantation

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ID: 254151
2018
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Ranked #8 of 58 articles by views in contemporary clinical trials communications

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Abstract
Purpose: To present the 13.5-year-survival of an autologous retinal pigment epithelium (RPE) and choroid graft transplantation with good visual acuity results. Observations: A 72-year old patient presented with a 5-weeks-old visual acuity deterioration to excentric finger counting at half a meter. Fundoscopy showed a fibrotic macular scar, a large subretinal hemorrhage, partly recent, combined with intraretinal fluid, blood, and hard exudates. RPE-choroid graft surgery was performed, and visual acuity improved to 20/32, and maintained up until 13.5 years postoperative. Microperimetry performed at the same time revealed a 3.4 dB sensitivity, with fixation on the graft. During the postoperative years glaucoma developed, an uveitis anterior was treated, and to treat a small Coats' like lesion; one bevacizumab injection was administered. Conclusions and importance: A best corrected visual acuity of 20/32 could be achieved and maintained up to 13.5 years after an RPE-choroid graft transplantation, despite an unfavorable preoperative presentation and some early and late complications. This case is a proof of principle that an RPE-choroid graft harvested from the midperiphery can support the macular metabolism up to 13.5 after surgery in a patient with severe exudative AMD. It also represents a rationale for pursuing stem cell derived RPE replacement. Anti-vascular endothelial growth factor injections are nowadays the mainstay of therapy for choroidal neovascularization and/or small hemorrhages and offer good results. Nevertheless, selected patients that cannot benefit from this therapy may profit from an autologous RPE-choroid graft transplantation. Keywords: Retinal pigment epithelium, Graft, Choroid, Transplantation, Long-term, Microperimetry
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zeeburg2018americanvisual Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Elsbeth J.T. van Zeeburg, Kristel J.M. Maaijwee, Jan C. van Meurs
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Journal contemporary clinical trials communications
Year 2018
DOI
DOI not found
URL
http://www.sciencedirect.com/science/article/pii/S2451993617301263
Keywords
ophthalmology

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