Surgical techniques of retinal pigment epithelium autotranslocation in the scarred neovascular age-related macular degeneration treatment

   Abstract

   Original article

   Surgical techniques of retinal pigment epithelium autotranslocation in the scarred neovascular age-related macular degeneration treatment

   S.V. Sosnovskii, E.V. Boiko, D.I. Shumova

   S. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg branch, St. Petersburg, Russian Federation
Mechnikov North-West State Medical University, St. Petersburg, Russian Federation

   Purpose. To evaluate the efficacy and safety of two surgical techniques of RPE autotranslocation in the scarred neovascular AMD treatment.

   Material and methods. Autotranslocation of pigment epithelium with pedicled RPE-graft was performed in 9 patients (the follow-up 12–48 months); with free RPE-graft – in 15 patients (the follow-up 6–38 months). Functional efficiency was assessed based on the dynamics of BCVA. The anatomical effect was assessed by OCT, safety – by the spectrum and frequency of complications.

   Results. The BCVA in the group of pedicled RPE-graft autotranslocation increased from 0.02±0.01 to 0.02±0.03 (p>0.05). BCVA improved in 3 patients (33.3%), deterioration – in 6 patients (66.7%). Complications developed in 8 patients (88,9%): central subretinal hemorrhages – 6 patients (66.7%), central subretinal fibrosis – 2 patients (22.2%), proliferative vitreoretinopathy – 6 patients (66.7%). The BCVA in the group of free RPE-graft autotranslocation increased from 0.05±0.03 to 0.1±0.07 (p<0.01). BCVA improved in 13 patients (33.3%), worsened in 1 patient (7%), and stable in 1 patient (7%). Complications developed in 6 patients (40%): macular hole – 2 patients (13.3%), macular epiretinal fibrosis – 2 patients (13.3%), proliferative vitreoretinopathy – 4 patients (26.6%), two complications simultaneously (proliferative vitreoretinopathy and macular hole, proliferative vitreoretinopathy and epiretinal fibrosis) – 2 patients (13.3%).

   Conclusion. Autotranslocation of pigment epithelium in the scarred neovascular of neovascular AMD can lead to improved vision. The free RPE-graft technique is preferred due to better functional results of surgical treatment and a lower incidence of complications.

   Key words: neovascular age-related macular degeneration, choroidal neovascularization, subretinal fibrosis, pigment epithelium autotranslocation

   For citation: Sosnovskii S.V., Boiko E.V., Shumova D.I. Surgical techniques of retinal pigment epithelium autotranslocation in the scarred neovascular age-related macular degeneration treatment. Fyodorov Journal of Ophthalmic Surgery. 2024;3(141): 50–60.

   doi: 10.25276/0235-4160-2024-3-50-60

   Corresponding author: Sergei V. Sosnovskii, svsosnovsky@mail.ru