There was no significant difference in clinical outcome following two different RPE transplantation techniques (RPE-suspension technique and the RPE-choroid-sheet technique) for the treatment of AMD.
Transplantation of RPE (maculoplasty) was introduced more than two decades ago, and is useful in the treatment of advanced AMD, geographic atrophy and/or anti-VEGF non-responders.
Fourteen consecutive patients with advanced exudative AMD were randomly assigned to RPE-choroid sheet transplantation (group 1) or RPE cell-suspension transplantation (group 2).
A gain of three or more lines in BCVA at 24 months was found in two patients in group 1 and in one patient in group 2, whereas a loss of vision of three or more lines occurred in one patient in each group.
This randomized study found that transplantation of RPE-choroid sheet and RPE-cell suspension enabled the maintenance of distance BCVA or in the best cases the restoration of foveal function in patients who were nonresponders or were not candidates for other treatments.
The functional outcome was comparable between both groups in this series and quite similar to the results reported in the literature.
In conclusion, transplantation of RPE offers an alternative approach in advanced AMD, and is also suitable for geographic AMD and other degenerative retinal diseases. However, the functional results with RPE transplantation techniques do not approach the levels of outcome seen with anti-VEGF treatment.
WHAT IT MEANS TO YOU: Despite the great success of anti-VEGF therapy for wet AMD, there remains a need for alternative treatments for those patients that do not respond to anti-VEGF therapy, or have dry AMD. Surgical treatments, such as maculoplasty, are continuing to evolve. This study finds that maculoplasty is able to maintain the vision of most patients with advanced AMD that undergo this procedure.Source:http://www.ncbi.nlm.nih.gov/pubmed/20610478