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Long-Term Outcome

van Romunde, Saskia H. M., MD*; Polito, Antonio, MD*; Peroglio Deiro, Antonio, MD*; Guerriero, Massimo, PhD; Pertile, Grazia, MD*

doi: 10.1097/IAE.0000000000001945
Original Study

Purpose: To investigate the long-term outcome of autologous retinal pigment epithelium –choroid transplantation with a peripheral retinotomy for exudative age-related macular degeneration.

Methods: In a retrospective study, we selected all patients who underwent a retinal pigment epithelium–choroid transplantation from 2007 through 2013. Exclusion criteria were age <60 years, <12 months of follow-up, and retinal pigment epithelium–choroid graft for other diseases than age-related macular degeneration. The main outcome measure was best-corrected visual acuity converted into logarithm of the minimum angle of resolution.

Results: In this study, 81 patients were included with a mean follow-up of 38 months (SD = 19). Median best-corrected visual acuity improved from 1.30 logarithm of the minimum angle of resolution (20/400 Snellen) to 0.90 logarithm of the minimum angle of resolution (20/160 Snellen) 1 year after surgery (P < 0.001). A ≥3-line gain was achieved in 43 patients (53%) 1 year postoperatively and 37 patients (46%) preserved their visual gain until last visit. Of 4 patients with an 8-year follow-up, 3 patients had a ≥6-line gain at last visit. Severe complications were submacular hemorrhage (n = 8, 10%), macular hole (n = 6, 7%), and proliferative vitreoretinopathy (n = 3, 4%).

Conclusion: Best-corrected visual acuity improved significantly after retinal pigment epithelium–choroid transplantation in patients with age-related macular degeneration and preservation of visual gain was possible in the long term.

Retinal pigment epithelium–choroidal transplantation is an alternative treatment for exudative age-related macular degeneration in cases that are unlikely to benefit from anti–vascular endothelial growth factor. Using a semicircular peripheral retinotomy instead of a parafoveal retinotomy, we found a clinically and statistically significant improvement postoperatively, which was maintained in the long term.

*Sacro Cuore Hospital, Department of Ophthalmology, Negrar (Verona), Italy; and

Department Computer Science, University of Verona, Verona, Italy.

Reprint requests: Antonio Polito, MD, Sacro Cuore Hospital, Via Don A. Sempreboni 5, 37024 Negrar (Verona) Italy; e-mail:

Supported by the Hospital Sacro Cuore—Don Calabria.

Paper presented at Nederlands Oogheelkundig Congres, Maastricht, the Netherlands, March 29, 2017.

None of the authors has any conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.