Long-term results after limited macular translocation surgery for wet age-related macular degeneration

PLoS One

Hisaaki Oshima¹  Kohei Ishikawa¹  Takeshi Iwase¹  Hiroko Terasaki¹  Kentaro Yamamoto¹ 

[1] Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

关键词: Eyes;    Surgical and invasive medical procedures;    Retina;    Fovea centralis;    Visual acuity;    Macular degeneration;    Vision;    Vasculogenesis;   

DOI  :  10.1371/journal.pone.0177241

学科分类：医学（综合）

来源: Public Library of Science

【 摘 要 】

Purpose To evaluate the long-term results of limited macular translocation (LMT) surgery with radial chorioscleral outfolding in patients with wet age-related macular degeneration (AMD) and subfoveal choroidal neovascularization (CNV). In addition, to identify the factors associated with the final best-corrected visual acuity (BCVA). Methods The medical records of 20 eyes of 20 consecutive patients (65.2±9.8 years) who had undergone LMT for the treatment of wet AMD and were followed for at least 5 years, were reviewed. The surgical outcomes including the BCVA, degree of foveal displacement, and complications were recorded. Results The mean foveal displacement was 1332 ± 393 μm after the LMT. The CNV was removed in 16 eyes and photocoagulated in 4 eyes. The mean preoperative VA was 0.83 ± 0.33 logMAR units which significantly improved to 0.59 ± 0.37 logMAR units at 1 year after the surgery (P = 0.015). This BCVA was maintained at 0.59 ± 0.41 logMAR units on the final examination. The final BCVA was significantly correlated with that at 1 year after the surgery (r = 0.83, P<0.001). Multiple linear regression analysis showed that the final BCVA was significantly correlated with the BCVA at 1 year after the surgery (P<0.001), a recurrence of a CNV (P = 0.001), and the age (P = 0.022). Conclusions LMT improves the BCVA significantly at 1 year, and the improved BCVA lasted for at least 5 years. These results indicate that the impaired function of the sensory retina at the fovea can recover on the new RPE after the displacement for at least 5 years. The ability to maintain good retinal function on the new RPE for a long period is important for future treatments of CNVs such as the transplantation of RPE cells and stem cells.

【 授权许可】

CC BY