Purpose:To evaluate the autologous translocation of peripheral choroid and retinal pigment epithelium(RPE)in 45 eyes of 43 patients with age-related macular degeneration(AMD).Design:Prospective nonrandomized study.Met...Purpose:To evaluate the autologous translocation of peripheral choroid and retinal pigment epithelium(RPE)in 45 eyes of 43 patients with age-related macular degeneration(AMD).Design:Prospective nonrandomized study.Methods:All patients had visual loss due to AMD(n=5 classic membranes,n=14 occult,n=2 mixed,n=16 pigment epithelial detachment(PED),n=5 subretinal hemorrhage,n=3 geographic atrophy).After extraction of the neovascular complex,an autologous peripheral full-thickness explant of RPE,Bruch membrane,and choroid was translocated from the midperiphery to themacula.Results:Preoperative distant visual acuity ranged from 20/800 to 20/40.Reading vision ranged from 1.4 logarithm of reading acuity determination(logRAD)to 0.5 logRAD(0.04 to 0.32 Snellen equivalent).Revision surgery was required in 22 eyes as a result of proliferative vitreoretinopathy(PVR),retinal detachment,macular pucker,or vitreous hemorrhage.In eight patients,the patch was renewed.At six months,distant visual acuity ranged from light perception to 20/50(increase of 15 letters in four eyes).Reading vision ranged from 1.4 to 0.4 logRAD.Visual outcome was unrelated to the type of AMD.Vascularization of the transplant was visible on indocyanine green(ICG)angiography in 40 of 42 eyes.In most patients,autofluorescence of the pigment epithelium was coincident with revascularization of the graft.Fixation on the patch was positively related to visual acuity.Conclusions:Autologous translocation of a full thickness transplant of choroid and RPE usually results in a vascularized and functioning graft.Vascularization was even achieved in patients with geographic atrophy.Fixation stability and microperimetry before the patch translocation may be helpful in selecting patients who will profit from surgery.展开更多
Purpose: To determine the proportion of age-related ophthalmologic diseases discovered in a healthy Japanese adult population, as well as to evaluate the age-related changes in intraocular pressure (IOP) in this popul...Purpose: To determine the proportion of age-related ophthalmologic diseases discovered in a healthy Japanese adult population, as well as to evaluate the age-related changes in intraocular pressure (IOP) in this population during a 10- year period. Methods: Ophthalmologic surveys were conducted in 1988 and 1998 at Tamaho-cho in Yamanashi Prefecture. The target population of the first survey was 1389 subjects over 40 years of age, and of these, 1250 subjects (473 men and 777 women) participated in the survey. Their mean age was 57.8± 11.9 years. Of these 1250 subjects, 245 subjects participated in the second ophthalmologic survey in 1998. The cases of glaucoma or age-related ophthalmologic diseases developing over the intervening 10-year period were determined among the subjects who had been diagnosed with no ophthalmologic abnormalities in the 1988 survey. We also compared the IOP values of the 219 subjects who were diagnosed with no ophthalmologic abnormalities in either the 1988 or the 1998 survey. Results: The number of cases in the 1998 survey with newly discovered ocular diseases were as follows: two cases (0.82% )-of normal-tension glaucoma, two cases (0.82% ) of epiretinal membrane, one case (0.41% ) of age-related macular degeneration, one case (0.41% ) of angle-closure glaucoma, and one case (0.41% ) of branch retinal vein occlusion. The mean IOP of the 219 subjects diagnosed with no ophthalmic abnormalities in either survey was 13.88 ± 3.04 mmHg in 1988, which declined significantly to 13.16 ± 2.75 mmHg in 1998 (P< 0.0001). Conclusions: The 10-year follow-up of the 245 subjects participating in both surveys showed one or two de novo cases of age-relatedmacular degeneration, epiretinal membrane, branch retinal vein occlusion, normal-tension glaucoma, or angle- closure glaucoma. IOP was found to decline significantly with age.展开更多
文摘Purpose:To evaluate the autologous translocation of peripheral choroid and retinal pigment epithelium(RPE)in 45 eyes of 43 patients with age-related macular degeneration(AMD).Design:Prospective nonrandomized study.Methods:All patients had visual loss due to AMD(n=5 classic membranes,n=14 occult,n=2 mixed,n=16 pigment epithelial detachment(PED),n=5 subretinal hemorrhage,n=3 geographic atrophy).After extraction of the neovascular complex,an autologous peripheral full-thickness explant of RPE,Bruch membrane,and choroid was translocated from the midperiphery to themacula.Results:Preoperative distant visual acuity ranged from 20/800 to 20/40.Reading vision ranged from 1.4 logarithm of reading acuity determination(logRAD)to 0.5 logRAD(0.04 to 0.32 Snellen equivalent).Revision surgery was required in 22 eyes as a result of proliferative vitreoretinopathy(PVR),retinal detachment,macular pucker,or vitreous hemorrhage.In eight patients,the patch was renewed.At six months,distant visual acuity ranged from light perception to 20/50(increase of 15 letters in four eyes).Reading vision ranged from 1.4 to 0.4 logRAD.Visual outcome was unrelated to the type of AMD.Vascularization of the transplant was visible on indocyanine green(ICG)angiography in 40 of 42 eyes.In most patients,autofluorescence of the pigment epithelium was coincident with revascularization of the graft.Fixation on the patch was positively related to visual acuity.Conclusions:Autologous translocation of a full thickness transplant of choroid and RPE usually results in a vascularized and functioning graft.Vascularization was even achieved in patients with geographic atrophy.Fixation stability and microperimetry before the patch translocation may be helpful in selecting patients who will profit from surgery.
文摘Purpose: To determine the proportion of age-related ophthalmologic diseases discovered in a healthy Japanese adult population, as well as to evaluate the age-related changes in intraocular pressure (IOP) in this population during a 10- year period. Methods: Ophthalmologic surveys were conducted in 1988 and 1998 at Tamaho-cho in Yamanashi Prefecture. The target population of the first survey was 1389 subjects over 40 years of age, and of these, 1250 subjects (473 men and 777 women) participated in the survey. Their mean age was 57.8± 11.9 years. Of these 1250 subjects, 245 subjects participated in the second ophthalmologic survey in 1998. The cases of glaucoma or age-related ophthalmologic diseases developing over the intervening 10-year period were determined among the subjects who had been diagnosed with no ophthalmologic abnormalities in the 1988 survey. We also compared the IOP values of the 219 subjects who were diagnosed with no ophthalmologic abnormalities in either the 1988 or the 1998 survey. Results: The number of cases in the 1998 survey with newly discovered ocular diseases were as follows: two cases (0.82% )-of normal-tension glaucoma, two cases (0.82% ) of epiretinal membrane, one case (0.41% ) of age-related macular degeneration, one case (0.41% ) of angle-closure glaucoma, and one case (0.41% ) of branch retinal vein occlusion. The mean IOP of the 219 subjects diagnosed with no ophthalmic abnormalities in either survey was 13.88 ± 3.04 mmHg in 1988, which declined significantly to 13.16 ± 2.75 mmHg in 1998 (P< 0.0001). Conclusions: The 10-year follow-up of the 245 subjects participating in both surveys showed one or two de novo cases of age-relatedmacular degeneration, epiretinal membrane, branch retinal vein occlusion, normal-tension glaucoma, or angle- closure glaucoma. IOP was found to decline significantly with age.
