A pedicled autologous choroid RPE patch: a technique to preserve perfusion

Marcin Stopa; Jarosław Kocięcki; Piotr Rakowicz; Andrzej Dmitriew

doi:10.5114/wiitm.2011.28910

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abstract:

Case report

A pedicled autologous choroid RPE patch: a technique to preserve perfusion

Marcin Stopa

,

Jarosław Kocięcki

,

Piotr Rakowicz

,

Andrzej Dmitriew

Videosurgery Miniinv 2012; 7 (3): 220-223

DOI: https://doi.org/10.5114/wiitm.2011.28910

Online publish date: 2012/06/22

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The aim of the study is to report a technique of a pedicled autologous choroid retinal pigment epithelium (RPE) patch that aims to preserve perfusion of the transplanted tissue. A case report of a patient with sudden vision deterioration due to submacular hemorrhage in age-related macular degeneration. The surgery involved a 180-degree peripheral retinectomy and the creation of a pedicled graft instead of an isolated one. Outcome measures included preoperative and postoperative visual acuity and optical coherence tomography scans at 1, 3, 6, 12 months and patch vascularization on postoperative indocyanine green angiography. Postoperatively the patch was positioned under the fovea with an intact pedicle. Indocyanine green angiography showed perfusion through the pedicle and patch vasculature on the third postoperative day. Best corrected visual acuity improved from 0.5/50 to 5/50 at 1 month and remained stable over 1 year follow-up. No choroidal neovascularization recurrence was observed. This case report demonstrates the feasibility of a pedicled RPE-choroid graft that is an alternative to a free isolated graft. Our modification of patch surgery, by demonstrating early perfusion, offers an advantage, similar to macular translocation, when photoreceptors are embedded in RPE and choroid with blood circulation immediately after the surgery.

keywords:

A pedicled autologous choroid RPE patch: a technique to preserve perfusion

Marcin Stopa , Jarosław Kocięcki , Piotr Rakowicz , Andrzej Dmitriew

retinal pigment epithelium choroid patch, age-related macular degeneration, vitrectomy

Marcin Stopa

,

Jarosław Kocięcki

,

Piotr Rakowicz

,

Andrzej Dmitriew