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Adaptation to monocular torsion after macular translocation
1Department of Ophthalmology, Duke University Medical Center, Durham, NC 27710, USA.
Summary
Macular translocation surgery improved vision in one patient with severe subretinal hemorrhage. While both patients experienced ocular torsion and strabismus, they adapted to monocular vision, suggesting it
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Age-related maculopathy can cause severe subretinal hemorrhage, impacting visual acuity.
- Macular translocation is a surgical technique to reposition the macula over healthy retinal pigment epithelium.
Observation:
- Two patients with severe subretinal hemorrhage underwent macular translocation surgery.
- The fovea was surgically rotated to an area of healthy retinal pigment epithelium.
Findings:
- Visual acuity improved from 20/200 to 20/80 in one patient; the other remained at 20/200.
- Both patients developed significant ocular torsion (up to 55 degrees) and strabismus.
- Successful subjective adaptation to monocular torsion occurred after eye occlusion, but binocular adaptation did not.
Implications:
- Macular translocation can be a viable treatment for severe subretinal hemorrhage, offering visual improvement in some cases.
- Patient willingness to accept monocular vision is crucial for adaptation to surgical-induced torsion.
- Ocular torsion and strabismus should not preclude consideration of this surgical option for eligible patients.