Reduction of iatrogenic RPE lesions in AMD patients: evidence for wound healing?

Graefes Arch Clin Exp Ophthalmol. 2008 Mar;246(3):345-52. doi: 10.1007/s00417-007-0658-6. Epub 2007 Aug 18.

Abstract

Purpose: Our purpose was to study retinal pigment epithelium (RPE) wound healing in patients with age-related macular degeneration (AMD).

Patients and methods: Abrasive debridement of nasal RPE was performed with a metal cannula during pars plana vitrectomy for foveal choroidal neovascularization (CNV) membrane excision combined with simultaneous autologous RPE transplantation. Fundus autofluorescence, fluorescein angiography images, and red-free pictures were taken initially within 1-2 weeks postoperatively, subsequently in 2-week intervals until 3 months, monthly until 6 months, and every 3 months thereafter. The borders of these lesions were measured; areas were calculated and compared using ArchiCad Software. Fourteen eyes of 14 patients suffering from AMD were included (nine women and four men, mean age 75.6 years +/-6.6 years).

Results: Six of 14 (42.9 %) patients showed a reduction of the RPE debrided area. The size of these lesions reduced 5.6-20% within 2 postoperative months compared with their size at first examination (from a mean of 13.7 mm2 +/- 7.2 at baseline to a mean of 12.8 mm2 +/- 6.7 at 2 months postoperatively). No further reduction of the lesions was seen after the 2 months. In eight cases, borders of the RPE debrided areas stayed stable during observation time.

Conclusions: Wound healing of abrasively debrided RPE monolayer defects in patients with AMD occurs to a certain extent in nearly half of the cases. This process seems to stop after 2 months.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Choroidal Neovascularization / etiology
  • Choroidal Neovascularization / physiopathology
  • Choroidal Neovascularization / surgery*
  • Debridement
  • Female
  • Fluorescein Angiography
  • Humans
  • Iatrogenic Disease / prevention & control*
  • Macular Degeneration / complications
  • Macular Degeneration / physiopathology
  • Macular Degeneration / surgery*
  • Male
  • Middle Aged
  • Pigment Epithelium of Eye / physiology*
  • Pigment Epithelium of Eye / transplantation
  • Vitrectomy
  • Wound Healing*