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

Elsbeth J T van Zeeburg, Matteo G Cereda, Sankha Amarakoon, Jan C van Meurs

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)134-45
Number of pages12
JournalOphthalmologica
Volume233
Issue number3-4
DOIs
Publication statusPublished - 2015

Keywords

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors/therapeutic use
  • Choroid/transplantation
  • Female
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Prospective Studies
  • Retinal Hemorrhage/therapy
  • Retinal Perforations/therapy
  • Retinal Pigment Epithelium/transplantation
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A/antagonists & inhibitors
  • Visual Acuity/physiology
  • Wet Macular Degeneration/drug therapy

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