Article
Choroidal neovascularization recurrence after autologous transplantation of retinal pigment epithelium and choroid in neovascular age-related macular degeneration
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Published: | September 21, 2010 |
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Introduction: Autologous transplantation of retinal pigment epithelium (RPE) and choroid was a therapy option for exudative age-related macular degeneration (AMD) before the anti vascular endothelial growth factor (anti-VEGF) era. Until now no choroidal neovascularization (CNV) recurrence in the center of the graft was ever reported.
Methods: A case report of a patient with recurrent CNV in the center of the autologous graft of RPE and choroid. Fluorescein, indocyanine green angiography, and optical coherence tomography (OCT) were done.
Results: After an autologous transplantation of RPE and choroid for neovascular AMD on the year 2004 visual acuity gain from 20/100 preoperatively to 20/25 postoperatively was seen, which remains stable up to 5 years. Five years and nine months after the transplantation visual acuity deterioration was noted. The fluorescein angiography shows a leakage in the center of the graft. In OCT a hyperreflective subretinal tissue with disruption of the RPE band was seen. Intravitreal bevacizumab was given.
Discussion: The transplantation of RPE, Bruch’s membrane and choroid from the periphery might improve and stabilize visual acuity in selected cases of neovascular AMD. However over time the graft might not withstand the metabolical need of the macula, inducing the CNV recurrence.