Abstract
Objectives: To report practicability and efficacy of autologous iris pigment epithelium (IPE) translocation in exudative age-related macular degeneration (ARMD) over one year The consecutive interventional case series included 56 patients with exudative ARMD. During vitrectomy the submacular neovascular membrane (CNV) was removed and IPE cells, harvested from a peripheral iridectomy, were injected into the submacular space. Included were patients with subfoveal occult CNV (11 eyes), classic CNV (10 eyes), mixed CNV (18 eyes), CNV with a pigment epithelial detachment (13 eyes) or with a hemorrhage (5 eyes). Outcome measures were visual acuity, foveal fixation, size of CNV and rate of recurrence based on fluorescence angiographic imaging.
Results: All patients underwent successful surgical removal of the CNV with consecutive subretinal IPE injection. Mean preoperative visual acuity (1.0 +/− 0.3 IogMAR units) did not change significantly after one year (1.0 +/− 0.3 IogMAR units). Ten eyes (17.8%) developed a recurrence. Fixation within the surgically denuded area could be demonstrated in 25 eyes (45%).
Conclusions: Autologous IPE translocation for ARMD over one year can preserve foveal function on a low level, but cannot improve visual acuity. IPE translocation is technically feasible with a low rate of complication. Continued research seems justified to improve functional outcome.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Algvere PV, Berglin L, Gouras P, Sheng Y, Kopp ED (1997) Transplantation of RPE in age-related macular degeneration: observations in disciform lesions and dry RPE atrophy. Graefes Arch Clin Exp Ophthalmol 235: 149–58
Avery RL, Fekrat S, Hawkins BS, Bressler NM (1996) Natural history of subfoveal subretinal hemorrhage in age-related macular degeneration. Retina 16: 183–9
Bressler NM, Bressler SB, Fine SL (1988) Age-related macular degeneration. Sury Ophthalmol 32: 375–413
Green WR, Enger C (1993) Age-related macular degeneration histopathologic studies. The 1992 Lorenz E. Zimmerman Lecture. Ophthalmology 100: 1519–35
Grossniklaus HE, Green WR (1998) Histopathologic and ultrastructural findings of surgically excised choroidal neovascularization. Submacular Surgery Trials Research Group. Arch Ophthalmol 116: 745–9
Hsu JK, Thomas MA, Ibanez H, Green WR (1995) Clinicopathologic studies of an eye after sub-macular membranectomy for choroidal neovascularization. Retina 15: 43–52
Hudson HL, Frambach DA, Lopez PF (1995) Relation of the functional and structural fundus changes after submacular surgery for neovascular age-related macular degeneration. Br J Ophthalmol 79: 417–23
Lambert HM, Capone A Jr, Aaberg TM, Sternberg P Jr, Mandell BA, Lopez PF (1992) Surgical excision of subfoveal neovascular membranes in age-related macular degeneration. Am J Ophthalmol 113: 257–62
Lappas A, Weinberger AW, Foerster AM, Kube T, Rezai KA, Kirchhof B (2000) Iris pigment epithelial cell translocation in exudative age-related macular degeneration. A pilot study in patients. Graefes Arch Clin Exp Ophthalmol 238: 631–41
Machemer R (1998) Macular translocation. Am J Ophthalmol 125: 698–700
Merrill PT, LoRusso FJ, Lomeo MD, Saxe SJ, Khan MM, Lambert HM (1999) Surgical removal of subfoveal choroidal neovascularization in age-related macular degeneration. Ophthalmology 106: 782–9
Peyman GA, Blinder KJ, Paris CL, Alturki W, Nelson NC Jr, Desai U (1991) A technique for retinal pigment epithelium transplantation for age-related macular degeneration secondary to extensive subfoveal scarring. Ophthalmic Surg 22: 102–8
Rezai KA, Lappas A, Farrokhsiar L, Kohen L, Wiedemann P, Heimann K (1997) Iris pigment epithelial cells of long evans rats demonstrate phagocytic activity. Exp Eye Res 65: 23–9
Scheider A, Gundisch O, Kampik A (1999) Surgical extraction of subfoveal choroidal new vessels and submacular haemorrhage in age-related macular degeneration: results of a prospective study. Graefes Arch Clin Exp Ophthalmol 237: 10–15
Sunness JS, Applegate CA, Gonzalez-Baron J (2000) Improvement of visual acuity over time in patients with bilateral geographic atrophy from age-related macular degeneration. Retina 20: 162–9
Thomas MA, Dickinson JD, Melberg NS, Ibanez HE, Dhaliwal RS (1994) Visual results after surgical removal of subfoveal choroidal neovascular membranes. Ophthalmology 101: 1384–96
Thomas MA, Kaplan Hi (1991) Surgical removal of subfoveal neovascularization in the presumed ocular histoplasmosis syndrome. Am J Ophthalmol 111: 1–7
Thumann G (2002) Potential of pigment epithelium transplantation in the treatment of AMD. Graefes Arch Clin Exp Ophthalmol 240: 695–7
Toonen F, Remky A, Janssen V, Wolf, S, Reim M (1995) Microperimetry in patients with central serous retinopathy. Ger J Ophthalmol 4: 311–14
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2004 Springer-Verlag/Wien
About this chapter
Cite this chapter
Lappas, A., Foerster, A.M.H., Weinberger, A.W.A., Coburger, S., Schrage, N., Kirchhof, B. (2004). Translocation of iris pigment epithelium in patients with exudative age-related macular degeneration — long term results. In: Binder, S. (eds) The Macula. Springer, Vienna. https://doi.org/10.1007/978-3-7091-7985-7_8
Download citation
DOI: https://doi.org/10.1007/978-3-7091-7985-7_8
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-7987-1
Online ISBN: 978-3-7091-7985-7
eBook Packages: Springer Book Archive