Autologous retina transplantation for refractory highly myopic macular holes: a long-term follow-up.

IF 2.1 3区医学 Q2 OPHTHALMOLOGY

Japanese Journal of Ophthalmology Pub Date : 2025-02-28 DOI:10.1007/s10384-025-01169-4

Matteo Mario Carlà, Carlos Mateo

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引用次数: 0

Abstract

Purpose: To evaluate long-term anatomical and functional outcomes of autologous retinal transplantation (ART) in refractory highly myopic macular holes (HMMHs).

Study design: Retrospective interventional analysis of 9 eyes with refractory HMMH undergoing ART.

Methods: Best-corrected visual acuity (BCVA, Snellen) and optical coherence tomography (OCT) were performed at baseline and each follow-up visit (1, 3, 6, 12, 24 months and the most recent). Preoperatively, we collected minimum linear diameter (MLD) and basal diameter (BD). Post-operatively, central macular thickness (CMT), external limiting membrane (ELM)/ellipsoid zone (EZ) visibility, macular edema (ME) and retinal pigmented epithelium (RPE) atrophy were evaluated.

Results: Mean follow-up duration was 46.0 ± 19.6 months. Anatomical success was reached in 7/9 eyes (78%). Median BCVA went from 0.05 (IQR 0.065) at baseline to 0.075 (IQR 0.069) at final follow-up (p = 0.25). Only one eye showed a 2-lines improvement, while BCVA was stable in 4/9 (44%) and worsened in 1 eye (12%). CMT progressively thickened in the first 6 months (177 ± 68 μm), but then decreased to 122 ± 50 μm at final follow-up. Graft merging with the surrounding retina was visible in two eyes, showing partial ELM/EZ recovery and good outcomes. Microcystic-like refractory ME (33%) and long-term RPE atrophy (22%) were reported, while delayed displacement of the graft was seen in one case 6 months after first surgery.

Conclusion: ART offered acceptable anatomical success but no visual improvement in our cohort. Lack of graft merging with the surrounding retina, persistent microcystic-like ME, RPE atrophy and hole recurrence were the most frequent shortfalls.

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自体视网膜移植治疗难治性高度近视黄斑孔：长期随访。

目的：评价自体视网膜移植（ART）治疗难治性高度近视黄斑孔（HMMHs）的长期解剖学和功能预后。研究设计：回顾性介入分析9眼难治性HMMH接受ART治疗。方法：在基线和每次随访（1、3、6、12、24个月和最近一次）时进行最佳矫正视力（BCVA、Snellen）和光学相干断层扫描（OCT）检查。术前，我们收集了最小线径（MLD）和基底径（BD）。术后观察黄斑中央厚度（CMT）、外限制膜(ELM)/椭球带（EZ）可见度、黄斑水肿（ME）、视网膜色素上皮（RPE）萎缩。结果：平均随访时间46.0±19.6个月。解剖成功率为7/9眼（78%）。中位BCVA从基线时的0.05 （IQR 0.065）降至最终随访时的0.075 (IQR 0.069) （p = 0.25）。只有1只眼出现2线改善，4/9（44%）眼BCVA稳定，1只眼恶化（12%）。CMT在前6个月逐渐增厚（177±68 μm），但在最终随访时降至122±50 μm。两只眼睛可见移植物与周围视网膜融合，显示ELM/EZ部分恢复和良好的结果。据报道，微囊样难治性ME（33%）和长期RPE萎缩（22%），而一例移植物在首次手术后6个月出现延迟移位。结论：在我们的队列中，ART提供了可接受的解剖成功，但没有视觉改善。最常见的缺点是移植物与周围视网膜缺乏融合，持续的微囊样ME， RPE萎缩和孔洞复发。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Japanese Journal of Ophthalmology 医学-眼科学

CiteScore

4.80

自引率

8.30%

发文量

审稿时长

6-12 weeks

期刊介绍： The Japanese Journal of Ophthalmology (JJO) was inaugurated in 1957 as a quarterly journal published in English by the Ophthalmology Department of the University of Tokyo, with the aim of disseminating the achievements of Japanese ophthalmologists worldwide. JJO remains the only Japanese ophthalmology journal published in English. In 1997, the Japanese Ophthalmological Society assumed the responsibility for publishing the Japanese Journal of Ophthalmology as its official English-language publication. Currently the journal is published bimonthly and accepts papers from authors worldwide. JJO has become an international interdisciplinary forum for the publication of basic science and clinical research papers.