Logbook of a Retinal Autograft

This study aimed to evaluate the prognosis of a retinal autograft that was used to treat a macular hole that occurred after repeated vitreoretinal surgeries. A patient underwent repeated vitreoretinal surgery due to retinal detachment in the right eye, and the internal limiting membrane was also removed during the surgeries. After silicone oil removal, the patient developed recurrent retinal detachment and macular hole, and for this reason a retinal autograft was applied to the macular hole and silicone tamponade was administered. The silicone oil was removed at postoperative 7 months, and the macular hole was observed to be closed on fundus examination at 18 months. The final visual acuity was 5/100. On optical coherence tomography (OCT), the hole in the detached retina was measured as 600 µm in diameter preoperatively, 1020 µm on the first postoperative day, gradually narrowed to 765 µm, and graft integration occurred. During follow-up, the accumulation of hyperreflective spots persisted on the inner surface of the graft tissue and in all vertically extending sections. In en face sections, it appeared as a hyperreflective arc between the graft and host retina with a shadowing artefact. In OCT angiography evaluation, a punctate multiple blood flow signal in the vertical axis of the graft was detected in the early phase at 3 months. This finding persisted at 1 month after silicone removal, and the flow signal disappeared with resorption of the cystic edema. These flow signals were in the same location as the areas of hyperreflective spots on structural OCT. In conclusion, structural OCT and OCT angiography are effective methods for the follow-up of retinal autograft integration into host tissue.