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A comparison of autologous transplantation of retinal pigment epithelium (RPE) monolayer sheet graft with RPE-Bruch's membrane complex graft in neovascular age-related macular degeneration.
Acta Ophthalmol. 2017 Sep; 95(6):e443-e452.AO

Abstract

PURPOSE

To compare the outcome after choroidal neovascular (CNV) membrane excision and retinal pigment epithelium (RPE) transplantation and make further evaluation of two types of RPE grafts on the visual function in patients with neovascular age-related macular degeneration (AMD), complicated by massive subretinal haemorrhage.

METHODS

We retrospectively reviewed 80 patients who underwent CNV membrane excision with or without RPE transplantation. Two types of RPE grafts were adopted, RPE-Bruch's membrane complex graft (subgroup 1) and RPE monolayer sheet graft (subgroup 2). Outcome measures included pre- and postoperative visual acuity score (VAS), clinical findings, complications and recurrence rates.

RESULTS

The mean VAS [Early Treatment of Diabetic Retinopathy Study (ETDRS)] in the CNV membrane excision group was 11.06 ± 18.28 at baseline and 14.41 ± 16.86 at follow-up (p = 0.12) in a mean follow-up period of 24.35 ± 9.31 months. While in subgroup 1, VAS increased from 22.62 ± 23.72 to 35.50 ± 24.46 (p = 0.02) in a mean period of 20.63 ± 6.25 months. The percentage of visual acuity (VA) improvement (at least two or more lines changed) in subgroup 1 is 62.5%, which is significantly higher than that in CNV excision group (23.5%), p = 0.02. In subgroup 2, VAS increased from 16.61 ± 27.98 to 29.16 ± 23.80 (p = 0.02) in a mean period of 21.72 ± 11.09 months. The percentage of VA improvement in subgroup 2 is 58.0%, which is also significantly higher than that in CNV excision group (23.5%), p = 0.02. Postoperative VA elevation was comparable between the two subgroups (p = 0.05). Complications including retinal detachment, proliferative vitreal retinopathy and CNV recurrence occurred in both techniques. Central fixation stability was observed in eight eyes in subgroup 1 and five eyes in subgroup 2.

CONCLUSIONS

The autologous RPE transplantation can increase the vision of patients with haemorrhagic AMD. Two types of autologous RPE grafts were both effective and comparable in restoring visual function and central fixation stability.

Authors+Show Affiliations

Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University Third Hospital, Beijing, China.Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University Third Hospital, Beijing, China.Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University Third Hospital, Beijing, China.Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University Third Hospital, Beijing, China.Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University Third Hospital, Beijing, China.Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University Third Hospital, Beijing, China.Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University Third Hospital, Beijing, China.Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University Third Hospital, Beijing, China.Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University Third Hospital, Beijing, China.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27496526

Citation

Lu, Yao, et al. "A Comparison of Autologous Transplantation of Retinal Pigment Epithelium (RPE) Monolayer Sheet Graft With RPE-Bruch's Membrane Complex Graft in Neovascular Age-related Macular Degeneration." Acta Ophthalmologica, vol. 95, no. 6, 2017, pp. e443-e452.
Lu Y, Han L, Wang C, et al. A comparison of autologous transplantation of retinal pigment epithelium (RPE) monolayer sheet graft with RPE-Bruch's membrane complex graft in neovascular age-related macular degeneration. Acta Ophthalmol. 2017;95(6):e443-e452.
Lu, Y., Han, L., Wang, C., Dou, H., Feng, X., Hu, Y., Feng, K., Wang, X., & Ma, Z. (2017). A comparison of autologous transplantation of retinal pigment epithelium (RPE) monolayer sheet graft with RPE-Bruch's membrane complex graft in neovascular age-related macular degeneration. Acta Ophthalmologica, 95(6), e443-e452. https://doi.org/10.1111/aos.13054
Lu Y, et al. A Comparison of Autologous Transplantation of Retinal Pigment Epithelium (RPE) Monolayer Sheet Graft With RPE-Bruch's Membrane Complex Graft in Neovascular Age-related Macular Degeneration. Acta Ophthalmol. 2017;95(6):e443-e452. PubMed PMID: 27496526.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparison of autologous transplantation of retinal pigment epithelium (RPE) monolayer sheet graft with RPE-Bruch's membrane complex graft in neovascular age-related macular degeneration. AU - Lu,Yao, AU - Han,Liang, AU - Wang,Changguan, AU - Dou,Hongliang, AU - Feng,Xuefeng, AU - Hu,Yuntao, AU - Feng,Kang, AU - Wang,Xin, AU - Ma,Zhizhong, Y1 - 2016/08/06/ PY - 2015/01/05/received PY - 2016/02/07/accepted PY - 2016/8/9/pubmed PY - 2017/11/29/medline PY - 2016/8/7/entrez KW - RPE monolayer sheet graft KW - RPE-Bruch's membrane complex graft KW - age-related macular degeneration KW - autologous retinal pigment epithelium (RPE) transplantation KW - choroidal neovascular membrane excision KW - subretinal haemorrhage SP - e443 EP - e452 JF - Acta ophthalmologica JO - Acta Ophthalmol VL - 95 IS - 6 N2 - PURPOSE: To compare the outcome after choroidal neovascular (CNV) membrane excision and retinal pigment epithelium (RPE) transplantation and make further evaluation of two types of RPE grafts on the visual function in patients with neovascular age-related macular degeneration (AMD), complicated by massive subretinal haemorrhage. METHODS: We retrospectively reviewed 80 patients who underwent CNV membrane excision with or without RPE transplantation. Two types of RPE grafts were adopted, RPE-Bruch's membrane complex graft (subgroup 1) and RPE monolayer sheet graft (subgroup 2). Outcome measures included pre- and postoperative visual acuity score (VAS), clinical findings, complications and recurrence rates. RESULTS: The mean VAS [Early Treatment of Diabetic Retinopathy Study (ETDRS)] in the CNV membrane excision group was 11.06 ± 18.28 at baseline and 14.41 ± 16.86 at follow-up (p = 0.12) in a mean follow-up period of 24.35 ± 9.31 months. While in subgroup 1, VAS increased from 22.62 ± 23.72 to 35.50 ± 24.46 (p = 0.02) in a mean period of 20.63 ± 6.25 months. The percentage of visual acuity (VA) improvement (at least two or more lines changed) in subgroup 1 is 62.5%, which is significantly higher than that in CNV excision group (23.5%), p = 0.02. In subgroup 2, VAS increased from 16.61 ± 27.98 to 29.16 ± 23.80 (p = 0.02) in a mean period of 21.72 ± 11.09 months. The percentage of VA improvement in subgroup 2 is 58.0%, which is also significantly higher than that in CNV excision group (23.5%), p = 0.02. Postoperative VA elevation was comparable between the two subgroups (p = 0.05). Complications including retinal detachment, proliferative vitreal retinopathy and CNV recurrence occurred in both techniques. Central fixation stability was observed in eight eyes in subgroup 1 and five eyes in subgroup 2. CONCLUSIONS: The autologous RPE transplantation can increase the vision of patients with haemorrhagic AMD. Two types of autologous RPE grafts were both effective and comparable in restoring visual function and central fixation stability. SN - 1755-3768 UR - https://www.unboundmedicine.com/medline/citation/27496526/A_comparison_of_autologous_transplantation_of_retinal_pigment_epithelium__RPE__monolayer_sheet_graft_with_RPE_Bruch's_membrane_complex_graft_in_neovascular_age_related_macular_degeneration_ L2 - https://doi.org/10.1111/aos.13054 DB - PRIME DP - Unbound Medicine ER -