Reduction of iatrogenic RPE lesions in AMD patients: evidence for wound healing?
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Published on: February 26, 2021
Doris Rabenlehner1, Boris V Stanzel, Ilse Krebs
1The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Lasersurgery, Vienna, Austria. doris.rabenlehner@mediatrain.at
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.
Insights
Retinal pigment epithelium (RPE) wound healing in age-related macular degeneration (AMD) patients shows partial recovery in nearly half of cases. This RPE healing process appears to stabilize after two months post-surgery.
Area of Science:
- Ophthalmology
- Regenerative Medicine
Background:
- Age-related macular degeneration (AMD) poses significant challenges to retinal health.
- Retinal pigment epithelium (RPE) defects can result from AMD treatments.
- Understanding RPE wound healing is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the wound healing process of the retinal pigment epithelium (RPE) in patients diagnosed with age-related macular degeneration (AMD).
Main Methods:
- Abrasive debridement of nasal RPE was performed during pars plana vitrectomy for choroidal neovascularization (CNV) excision and autologous RPE transplantation.
- Serial imaging (fundus autofluorescence, fluorescein angiography, red-free) was conducted postoperatively for up to 6 months.
- Lesion areas were measured and analyzed using ArchiCad Software in 14 AMD patients.
Main Results:
- 42.9% of patients exhibited a reduction in the debrided RPE area.
- Lesion sizes decreased by 5.6-20% within the first two postoperative months.
- No further significant RPE lesion size reduction was observed after two months; borders remained stable in eight cases.
Conclusions:
- Wound healing of debrided RPE monolayer defects in AMD patients occurs to a limited extent in approximately half of the cases.
- The RPE healing process appears to reach a plateau approximately two months after the surgical intervention.