Autologous neurosensory retinal transplantation for recurrent macular hole retinal detachment in highly myopic eyes

Li, Yanzi; Li, Zhaohui; Xu, Can; Liu, Yong; Kang, Xueqin; Wu, Jianhua

doi:10.1111/aos.14442

Cited by 16 publications

(17 citation statements)

References 44 publications

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“…However, we have not yet carried out these technologies for legal reasons. In this study, we had five eyes that underwent ANRT and SO refilling surgery, and 80% of cases (4/5) were finally anatomically reattached successfully (RD reattachment and MH closure), which is consistent with that in our previous report 39 . Recently, an international multicenter study also reported that ANRT could obtain a high reclosure rate of 87.8% in the treatment of an unclosed high-myopia MH after PPV combined with ILM peeling 40 .…”

Section: Discussionsupporting

confidence: 88%

Inverted internal limiting membrane flap technique for retinal detachment due to macular holes in high myopia with axial length ≥ 30 mm

Chen

Han

et al. 2022

Sci Rep

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To compare the efficacy of internal limiting membrane (ILM) flap covering to that of ILM flap insertion for the treatment of macular hole retinal detachment (MHRD) in highly myopic eyes with axial length (AL) ≥ 30 mm. We retrospectively analysed the medical records of 48 MHRD patients with high myopia (AL ≥ 30 mm). According to different surgical methods, the patients were divided into a covering group (23 eyes) and an insertion group (25 eyes). The rate of retinal reattachment and MH closure were compared between the two groups, and the related factors affecting the initial anatomical results were analysed. After primary vitrectomy and single silicone oil removal, there were 18 eyes (78.3%) in the covering group, and 20 eyes (80.0%) in the insertion group had retinal reattachment (P = 1.000). Moreover, 16 eyes (69.6%) in the covering group and 17 eyes (68.0%) in the insertion group had their MHs sealed (P = 0.907). The best-corrected visual acuity (BCVA) at 12 months and the improvement in BCVA postoperatively in the two groups were not statistically significant (P = 0.543, 0.955). Logistic regression analysis showed that elongated AL (OR = 1.844, 95% CI 1.037–3.280, P = 0.037) and higher choroidal atrophy (OR = 2.986, 95% CI 1.011–8.821, P = 0.048) were risk factors affecting initial anatomical success. For extremely high-myopia MHRD with AL ≥ 30 mm, ILM flap covering and insertion can both effectively seal the MH and promote retinal reattachment, but the visual function improvement may still be limited. The longer the AL and the higher the choroidal atrophy, the greater is the risk of initial anatomical failure.

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Section: Discussionsupporting

confidence: 88%

Inverted internal limiting membrane flap technique for retinal detachment due to macular holes in high myopia with axial length ≥ 30 mm

Chen

Han

et al. 2022

Sci Rep

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“…Some scholars have studied autologous or allogenic lens capsular flap transplantation 4 , autologous neurosensory retinal free flap (ANRFF) transplantation 5 and other techniques for use in patients with recurrent macular holes. However, the above techniques are still associated with certain trauma and technical difficulty, and "the losses outweigh the gains".…”

Section: Discussionmentioning

confidence: 99%

“…Patients with recurrent macular holes have often undergone pars plana vitrectomy (PPV) more than once. Therefore, the macular area in these patients may not have an adequate inner limiting membrane 3 – 5 . This means that the reoperations may be extremely difficult, and the results may be poor.…”

Section: Introductionmentioning

confidence: 99%

The use of biological amniotic membranes in the treatment of recurrent macular holes

Qiao

Xie

Zou

et al. 2022

Sci Rep

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To evaluate the clinical therapeutic effects of a technique in which biological amniotic membranes (bAMs) are used in the treatment of patients with recurrent macular holes. In this prospective nonrandomized case series study, 23 eyes of 23 patients with recurrent macular holes who had already undergone surgery with pars plana vitrectomy with internal limiting membrane peeling were evaluated. In the surgery, a bAM was used to cover the macular area, and C3F8 tamponade was performed on these patients. Phacoemulsification combined with intraocular lens implantation was performed simultaneously in patients who had cataracts. Patients were followed up for at least half a year. The main outcomes were whether the macular hole closed, the morphological changes in the macular graft, the best-corrected visual acuity, intraocular pressure (IOP) and other indicators. In all eyes, the recurrent macular holes were closed. Two cases (8.69%, 2/23) had bAM shifting half a month after surgery, and these patients underwent a second surgery to adjust the position of the bAM and perform C3F8 tamponade. In the 6-month follow-up, 21 patients (91.30%, 21/23) had improved visual acuity (VA), and 2 patients (8.69%, 2/23) had no change in VA. The mean VA increased from 1.73 ± 0.32 before surgery to 1.12 ± 0.42 after surgery (t = 10.63, P = 0.00 < 0.01), and the mean IOP decreased from 22.13 ± 5.56 before surgery to 17.23 ± 1.71 after surgery (t = 5.14, P = 0.00 < 0.01). No serious complications occurred in any of the cases. The technique of using a biological amniotic membrane can be an effective treatment for patients with recurrent macular holes.

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“…10,30 Anatomic, Visual, and Functional Outcomes When analyzing ART series of at least five eyes, the weighted mean closure rate was 88% (range: 66.7%-100%) for a variety of MH repairs (Table 1). 9,10,25,[28][29][30][31][32][33][34] Patients with larger MH diameters demonstrated lower rates of successful closure. 9,34 Cases without successful closure usually did not achieve graft integration into the surrounding tissue.…”

Section: Surgical Techniquementioning

confidence: 99%

“…9 Many patients gained several lines of visual acuity (Table 2). 9,10,25,[28][29][30][31][32][33][34] In the largest ART series, 12% of patients attained a postoperative visual acuity of 20/50 or better after ART for primary or refractory MH; none of these patients underwent ART for combined MH-retinal detachment. 28 Anatomic features associated with significant visual acuity improvement included ellipsoid zone reconstitution and alignment of neurosensory layers (ANLs) (graft inner plexiform layer to host inner plexiform layer, graft outer plexiform layer to host outer plexiform layer, etc.).…”

Section: Surgical Techniquementioning

confidence: 99%

Autologous Neurosensory Retinal Transplantation

Patel

Mahmoud

Kazahaya

et al. 2021

Retina

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Purpose: To review the autologous retinal transplantation surgical technique, indications, rationale, and current outcomes of data published to date.Methods: Review of surgical technique, preoperative and postoperative best-corrected visual acuity, and macular hole (MH) closure rate in studies with at least five eyes.Results: The weighted average macular hole closure rate is 88%, with a MH closure rate ranging from 66.7% to 100%. The weighted average best-corrected visual acuity improved from mean logarithm of the minimum angle of resolution 1.35 (Snellen equivalent of 20/450) preoperatively to mean logarithm of the minimum angle of resolution 1.02 (Snellen equivalent of 20/210) postoperatively. From the largest autologous retinal transplantation case series, 37% of patients gained 3 or more lines of visual acuity after autologous retinal transplantation for primary or refractory MHs and 74% gained 3 or more lines of visual acuity after autologous retinal transplantation for MH-retinal detachments. Functional improvement including negative Watzke-Allen sign and conversion from positive to negative scotoma was reported in large case series.Conclusion: Autologous retinal transplantation is a promising technique for closure of large and refractory MHs otherwise difficult to repair with conventional techniques. This technique may allow for replacement of neural tissue in the macula through cell rehabilitation and regeneration through presumed ectopic synaptogenesis, retinal progenitor cell differentiation and integration, and/or retinal progenitor cell material transfer to host neurons.

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Autologous neurosensory retinal transplantation for recurrent macular hole retinal detachment in highly myopic eyes

Cited by 16 publications

References 44 publications

Inverted internal limiting membrane flap technique for retinal detachment due to macular holes in high myopia with axial length ≥ 30 mm

Inverted internal limiting membrane flap technique for retinal detachment due to macular holes in high myopia with axial length ≥ 30 mm

The use of biological amniotic membranes in the treatment of recurrent macular holes

Autologous Neurosensory Retinal Transplantation

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