Purpose: To investigate whether patients with exudative age-related macular degeneration and a submacular hemorrhage, retinal pigment epithelium (RPE) tear or nonresponders to anti-vascular endothelial growth factor (VEGF) benefit more from a free RPE-choroid graft transplantation surgery than from (continuation of) anti-VEGF treatment. Procedures: A total of 20 patients were included in this prospective, international, multicenter, randomized intervention study. Results: The change in the mean number of Early Treatment of Diabetic Retinopathy Study (ETDRS) letters in the graft group 1 year postoperatively was -15 (range -54 to +26), whilst 2 patients experienced a gain of >10 letters. The median preoperative visual acuity (VA) was 0.75 logMAR (range 0.46-2.8), and the mean postoperative VA was 1.48 logMAR (range 0.14-2.8). The change in the mean number of ETDRS letters in the anti-VEGF group was -8 (range -26 to +6); no patients experienced a >10 letter gain. The median preoperative VA was 1.36 logMAR (range 0.58-1.6), and the median postoperative VA was 1.42 logMAR (range 0.44-1.66). Conclusions: The included patient group is far too small to draw conclusions. However, both gain and loss of VA may be experienced by patients undergoing either treatment method; more gain might be possible for patients with a graft in the absence of complications.

Age-related macular degeneration, Anti-vascular endothelial growth factor, Retinal pigment epithelium-choroid graft surgery
dx.doi.org/10.1159/000380829, hdl.handle.net/1765/81733
Department of Ophthalmology

van Zeeburg, E.J.T, Cereda, M.G, Amarakoon, S, & van Meurs, J.C. (2015). Prospective, randomized intervention study comparing retinal pigment epithelium-choroid graft surgery and anti-VEGF therapy in patients with exudative age-related macular degeneration. Ophthalmologica, 233, 134–145. doi:10.1159/000380829