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Vision declined in most macular translocation patients in long-term follow-up study
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Visual function declined in most patients with follow-up of more than 5 years in a study of macular translocation for age-related macular degeneration, according to a recent publication. The choroidal grafts survived in all patients, but rescue of visual function was transient and foveal fixation was lost, investigators said.
Robert E. MacLaren, DPhil, FRCS, and colleagues at Moorfields Eye Hospital in London contacted the four surviving patients from a nine-patient series of patients who underwent macular retinal pigment epithelium translocation surgery for choroidal neovascularization associated with AMD. Two-year postoperative data on these patients had been previously published.
The success of RPE translocation at 5 years or more was assessed by visual acuity, imaging, angiography and maintenance of overlying foveal fixation. Comparisons from this long-term follow-up were made with the patients’ 2-year data.
Over the long term, visual acuity declined in three patients and improved slightly in one patient.
“Significantly, all four patients had lost foveal fixation and autofluorescence of translocated RPE, which had been present at the original 2-year follow-up assessment,” the authors said. The grafts still seemed viable, and no patient had recurrence of neovascularization, the authors added.
“The long-term loss of foveal fixation and graft autofluorescence might be explained by chronic photoreceptor apoptosis, initiated by either surgery or the disease itself,” the researchers said. “Caution should be applied when drawing firm conclusions from similar studies that provide data after only 2 years’ follow-up.”
The study is published in the December issue of Ophthalmology.