A Free Retinal Pigment Epithelium–Choroid Graft in Patients With Exudative Age-Related Macular Degeneration: Results up to 7 Years

Zeeburg, Elsbeth J. T. van; Maaijwee, Kristel Johanna Maria; Missotten, Tom; Heimann, Heinrich; Meurs, Jan C. van

doi:10.1016/j.ajo.2011.06.007

Cited by 113 publications

(83 citation statements)

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“…[3][4][5][6][7] Functional loss due to AMD was previously demonstrated by findings of reduced visual field sensitivity in retinal locations with drusen compared with nondrusen locations, using scanning laser ophthalmoscope (SLO) perimetry and microperimetry. [8][9][10][11] In contrast, other studies reported no difference in sensitivity between drusen and nondrusen areas.…”

Section: Resultsmentioning

confidence: 99%

Relationship between Retinal Layer Thickness and the Visual Field in Early Age-Related Macular Degeneration

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Hood

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To quantify and compare the structural and functional changes in subjects with early age-related macular degeneration (AMD), using spectral-domain optical coherence tomography (SD-OCT) and microperimetry.METHODS. Twenty-one eyes of 21 subjects with early AMD were examined. MP-1 10-2 visual fields (VFs) and SD-OCT line and detail volume scans were acquired. The thicknesses of the outer segment (OS; distance between inner segment ellipsoid band and upper retinal pigment epithelium [RPE] border) and RPE layers and elevation of the RPE from Bruch's membrane were measured using a computer-aided manual segmentation technique. Thickness values were compared with those for 15 controls, and values at locations with VF total deviation defects were compared with values at nondefect locations at equivalent eccentricities. RESULTS.Sixteen of 21 eyes with AMD had VF defects. Compared with controls, line scans showed significant thinning of the OS layer (P ¼ 0.006) and thickening and elevation of the RPE (P ¼ 0.037, P ¼ 0.002). The OS layer was significantly thinner in locations with VF defects compared with locations without defects (P ¼ 0.003). There was a negligible difference between the retinal layer thickness values of the 5 eyes without VF defects and the values of normal controls.CONCLUSIONS. In early AMD, when VF defects were present, there was significant thinning of the OS layer and thickening and elevation of the RPE. OS layer thinning was significantly associated with decreased visual sensitivity, consistent with known photoreceptor loss in early AMD. For AMD subjects without VF defects, thickness values were normal. The results highlight the clinical utility of both SD-OCT retinal layer quantification and VF testing in early AMD. (Invest Ophthalmol Vis Sci. 2012;53:7618-7624) DOI:10.1167/iovs.12-10361 A ge-related macular degeneration (AMD) is the third leading cause of blindness worldwide, accounting for 8.7% of blindness in the global population.1 Due to the increase in the average lifespan of the elderly population, it is expected that 17.8 million individuals in the United States will be affected by 2050.2 In view of the relevance of AMD as a public health issue, it is important to understand the changes that occur in the early stages of disease, which may lead to improved future intervention strategies.There has been recent interest in the use of fundus perimetry, also known as microperimetry, as an outcome measure in clinical trials of macular disease.3-7 Functional loss due to AMD was previously demonstrated by findings of reduced visual field sensitivity in retinal locations with drusen compared with nondrusen locations, using scanning laser ophthalmoscope (SLO) perimetry and microperimetry. [8][9][10][11] In contrast, other studies reported no difference in sensitivity between drusen and nondrusen areas. 12Optical coherence tomography (OCT) is a noninvasive imaging technique that provides cross-sectional images of retinal layer structure, useful for visualization of pathology. Spectral-domain O...

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Section: Resultsmentioning

confidence: 99%

Relationship between Retinal Layer Thickness and the Visual Field in Early Age-Related Macular Degeneration

Acton

Rjh

Hood

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…Given that the diseased RPE is a major component of AMD, attempts have been made to replace the RPE at the macula, either by moving the macula to the non-diseased periphery or by grafting new RPE under the macula. Sources of RPE cells that have been used in these procedures include rotated pedicled flaps of peripheral RPE-choroid, autologous free RPE-choroid grafts, sheets of foetal RPE and cell suspensions of peripheral RPE (Binder et al, 2007;da Cruz et al, 2007;Chen et al, 2009;van Zeeburg et al, 2012). In the last approach, one of the major drawbacks is that there is no guarantee that the cells in suspension can first attach to the diseased Bruch's membrane (Tsukahara et al, 2002).…”

Section: Retinal Transplantation In Amd: Proof Of Principlementioning

confidence: 99%

Stem cells in retinal regeneration: past, present and future

et al. 2013

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SummaryStem cell therapy for retinal disease is under way, and several clinical trials are currently recruiting. These trials use human embryonic, foetal and umbilical cord tissue-derived stem cells and bone marrow-derived stem cells to treat visual disorders such as age-related macular degeneration, Stargardt's disease and retinitis pigmentosa. Over a decade of analysing the developmental cues involved in retinal generation and stem cell biology, coupled with extensive surgical research, have yielded differing cellular approaches to tackle these retinopathies. Here, we review these various stem cell-based approaches for treating retinal diseases and discuss future directions and challenges for the field.

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“…Preliminary reports of RPE tears treated with an RPE-choroid graft showed promising results [10]. We have shown in previous publications that an RPE-choroid graft can be successful for up to 7 years in patients with various etiologies [11,12]. …”

Section: Introductionmentioning

confidence: 99%

Prospective, Randomized Intervention Study Comparing Retinal Pigment Epithelium-Choroid Graft Surgery and Anti-VEGF Therapy in Patients with Exudative Age-Related Macular Degeneration

et al. 2015

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Purpose: To investigate whether patients with exudative age-related macular degeneration and a submacular hemorrhage, retinal pigment epithelium (RPE) tear or nonresponders to anti-vascular endothelial growth factor (VEGF) benefit more from a free RPE-choroid graft transplantation surgery than from (continuation of) anti-VEGF treatment. Procedures: A total of 20 patients were included in this prospective, international, multicenter, randomized intervention study. Results: The change in the mean number of Early Treatment of Diabetic Retinopathy Study (ETDRS) letters in the graft group 1 year postoperatively was -15 (range -54 to +26), whilst 2 patients experienced a gain of >10 letters. The median preoperative visual acuity (VA) was 0.75 logMAR (range 0.46-2.8), and the mean postoperative VA was 1.48 logMAR (range 0.14-2.8). The change in the mean number of ETDRS letters in the anti-VEGF group was -8 (range -26 to +6); no patients experienced a >10 letter gain. The median preoperative VA was 1.36 logMAR (range 0.58-1.6), and the median postoperative VA was 1.42 logMAR (range 0.44-1.66). Conclusions: The included patient group is far too small to draw conclusions. However, both gain and loss of VA may be experienced by patients undergoing either treatment method; more gain might be possible for patients with a graft in the absence of complications.

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A Free Retinal Pigment Epithelium–Choroid Graft in Patients With Exudative Age-Related Macular Degeneration: Results up to 7 Years

Cited by 113 publications

References 37 publications

Relationship between Retinal Layer Thickness and the Visual Field in Early Age-Related Macular Degeneration

Relationship between Retinal Layer Thickness and the Visual Field in Early Age-Related Macular Degeneration

Stem cells in retinal regeneration: past, present and future

Prospective, Randomized Intervention Study Comparing Retinal Pigment Epithelium-Choroid Graft Surgery and Anti-VEGF Therapy in Patients with Exudative Age-Related Macular Degeneration

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