The end of submacular surgery for age-related macular degeneration? A meta-analysis

Falkner, C.; Leitich, Harald; Frommlet, Florian; Bauer, Péter; Binder, Susanne

doi:10.1007/s00417-005-0184-3

Cited by 29 publications

(17 citation statements)

References 89 publications

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“…This is in accordance to a recently published meta-analysis, 19 showing that, after MR an improvement of VA of two or more lines was found in 31% and a deterioration of two or more lines in 27%. Only for patients with subretinal haemorrhages, estimates were significantly different (improvement of VA 62%, deterioration of VA 13%).…”

Section: Discussionsupporting

confidence: 93%

Surgical management of subfoveal choroidal neovascular membranes in age-related macular degeneration by macular relocation: experiences of an early-stopped randomised clinical trial (MARAN Study)

Joussen

Wong

Walter

et al. 2009

Eye

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Rationale The MARAN (Macular Relocation in Age-related Neovascular disease) trial was planned to assess the effectiveness of full macular relocation (MR) in patients with neovascular age-related macular degeneration (AMD). Design Randomised, prospective, controlled clinical trial. Methods Patients suffering from visual loss because of AMD were randomised to either surgery or a control group receiving standard treatment (observation or photodynamic therapy (PDT)). The primary end point was the change of visual acuity (VA) (ETDRS) 52 weeks after randomisation compared with initial VA, and secondary end points included reading performance, contrast sensitivity, stability of fixation, eye-specific quality of life, and the absolute number of letters read correctly at 52 weeks compared with initial examination. Results Owing to early determination, only 28 patients were included in the study. The study did not show a difference between the two groups with respect to the final visual result or any of the secondary outcomes measured. The study was limited by the low recruitment that was, at least in part, attributed to the inherent risks for those patients randomised to the surgical arm of the study as well as to the emerging new treatments for AMD. Conclusion The results of the MARAN trial failed to recruit a sufficient number of patients and a superiority of surgery over observation or PDT in patients with exudative AMD was not shown. There was a trend that the reading function was superior after surgery. In the light of the new pharmacological treatments, surgical options such as MR will be an option for only selected cases.

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Section: Discussionsupporting

confidence: 93%

Surgical management of subfoveal choroidal neovascular membranes in age-related macular degeneration by macular relocation: experiences of an early-stopped randomised clinical trial (MARAN Study)

Joussen

Wong

Walter

et al. 2009

Eye

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“…35,36 In a metaanalysis of subretinal membrane excision over a 5-year period in 677 cases, we found improvement in 33% overall and deterioration in 25 5%; however, small studies with shorter observation times and classic as well as occult membranes were included. 37 When membrane excision was compared with laser treatment in a randomized prospective multicenter study comparable results were found after 2 years. 38 Nevertheless, laser and PDT treatment have limited indications related to the membrane characteristics on fluorescein angiography, exact boundaries, and lesional size and are applicable in only 20% of cases with neovascular AMD.…”

Section: Discussionsupporting

confidence: 57%

Outcome of Transplantation of Autologous Retinal Pigment Epithelium in Age-Related Macular Degeneration: A Prospective Trial

Binder

Krebs

Hilgers

et al. 2004

Invest. Ophthalmol. Vis. Sci.

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207

121

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“…At least 31 studies were subsequently published on this surgery alone from 1992-2004. 10 In 1997, Lewis et al compared two groups undergoing surgical excision of subfoveal CNV, one tPA-assisted and one without, with one year follow-up. In this study of 80 patients, median preoperative visual acuity (VA) was 20/320.…”

Section: A R Skaf and T H Mahmoudmentioning

confidence: 98%

Surgical Treatment of Age-Related Macular Degeneration

Skaf

Mahmoud

2011

Seminars in Ophthalmology

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Choroidal neovascularization (CNV) and geographic atrophy (GA) are serious and potentially devastating complications of age-related macular degeneration (AMD), a leading cause of blindness in the developed world. While anti-vascular endothelial growth factor (VEGF) therapies have emerged as the current standard treatment of choice for choroidal neovascularization, the requirement for indefinite injections places a tremendous burden on physicians and patients, and may have disappointing outcomes in hemorrhagic neovascular AMD. No superior agents exist to treat large subretinal hemorrhage and geographic atrophy. Over the years, several vitreoretinal surgical approaches have been developed to treat macular degeneration, and these surgical options may still play a role in the management of specific complications of AMD. This review summarizes the principles, techniques, and results of surgical treatments for neovascular and non-neovascular age-related macular degeneration, with emphasis on submacular surgery for removal of CNV, full and limited macular translocation, retinal pigment epithelium, and choroid transplants as well as treatment of thick subretinal hemorrhage.

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The end of submacular surgery for age-related macular degeneration? A meta-analysis

Cited by 29 publications

References 89 publications

Surgical management of subfoveal choroidal neovascular membranes in age-related macular degeneration by macular relocation: experiences of an early-stopped randomised clinical trial (MARAN Study)

Surgical management of subfoveal choroidal neovascular membranes in age-related macular degeneration by macular relocation: experiences of an early-stopped randomised clinical trial (MARAN Study)

Outcome of Transplantation of Autologous Retinal Pigment Epithelium in Age-Related Macular Degeneration: A Prospective Trial

Surgical Treatment of Age-Related Macular Degeneration

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