Structural Changes in the Macular Region after Transplantation of the Autologous Retinal Pigment Epithelium in Neovascular Age-related Macular Degeneration with Subretinal Hemorrhage
https://doi.org/10.18008/18165095-2025-4-811-820
Abstract
Purpose: to investigate the structural changes in the macular region after transplantation of autologous retinal pigment epithelium (RPE) in patients with neovascular age-related macular degeneration (nAMD) complicated by subretinal hemorrhage.
Patients and methods. The prospective study included 14 patients with widespread nAMD complicated by extensive SRH of 46.5 (38.3; 83.0) days duration, for which autologous RPE transplantation was performed. During OCT before and 6 months after surgery, changes in the thickness of the neuroretina, the thickness of the RPE and choroidea, the presence of hyperreflective foci, the type of edema, the preservation of the ellipsoid zone, the structure of the subretinal material before surgery and the structure of the RPE patch after treatment were studied, and the relationship with BCVA was analyzed.
Results. In all cases, significant retinal structural abnormalities were observed before the RPE transplantation. After the surgery, there was a significant increase in the maximum thickness of RPE in the macula from 22.5 (19.0; 27.0) to 29.5 (26.3; 35.8) microns (p = 0.03). The thickness of the RPE in the fovea also increased from 1 (0; 3.8) to 15.5 (12.0; 23.3) microns (p = 0.014). Additionally, there was partial recovery of the ellipsoid zones in the fovea and parafovea. After 6 months, the value of BCVA correlated with the presence of preserved ellipsoid zone before treatment in the parafovea (r = 0.62, p = 0.018) and after RPE transplantation in the fovea (r = 0.64, p = 0.016).
Conclusion. Transplantation of autologous RPE in patients with nAMD complicated SRH can significantly improve the functional state of the macula due to the restoration of its structure. An important OCT-marker affecting the functional outcomes of surgical treatment is the preservation of the ellipsoid zone in the fovea and parafovea.
Keywords
age-related macular degeneration,
autotranslocation,
transplantation,
retinal pigment epithelium,
subretinal hemorrhage
Supporting agencies: no author has a financial or property interest in any material or method mentioned
About the Authors
S. V. Sosnovskiy
St. Petersburg Branch of S. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation
Russian Federation
Sosnovskij Sergey V. - PhD, deputy director.
Yaroslava Gasheka str., 21, Saint Petersburg, 192283
E. V. Boiko
St. Petersburg Branch of S. Fyodorov Eye Microsurgery Federal State Institution; St. Petersburg State University; North-Western State Medical University named after I.I. Mechnikov
Russian Federation
Russian Federation
Boiko Ernest V. - MD, Professor, director, head of the Ophthalmology Department.
Yaroslava Gasheka str., 21, Saint Petersburg, 192283; Universitetskaya emb., 7–9, St. Petersburg, 199034; Kirochnaya str., 41, Saint Petersburg, 191015
A. A. Suetov
St. Petersburg Branch of S. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation
Russian Federation
Suetov Alexey A. - PhD, ophthalmologist.
Yaroslava Gasheka str., 21, Saint Petersburg, 192283
I. E. Panova
St. Petersburg Branch of S. Fyodorov Eye Microsurgery Federal State Institution; St. Petersburg State University; North-Western State Medical University named after I.I. Mechnikov
Russian Federation
Russian Federation
Panova Irina E. - MD, Professor, deputy director, Professor of the Ophthalmology Department.
Yaroslava Gasheka str., 21, Saint Petersburg, 192283; Universitetskaya emb., 7–9, St. Petersburg, 199034; Kirochnaya str., 41, Saint Petersburg, 191015
T. A. Doktorova
St. Petersburg Branch of S. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation
Russian Federation
Doktorova Taisiia A. - ophthalmologist.
Yaroslava Gasheka str., 21, Saint Petersburg, 192283
D. I. Shumova
St. Petersburg Branch of S. Fyodorov Eye Microsurgery Federal State Institution
Russian Federation
Russian Federation
Shumova Dariya I. ophthalmologist.
Yaroslava Gasheka str., 21, Saint Petersburg, 192283
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Review
For citations:
Sosnovskiy S.V., Boiko E.V., Suetov A.A., Panova I.E., Doktorova T.A., Shumova D.I. Structural Changes in the Macular Region after Transplantation of the Autologous Retinal Pigment Epithelium in Neovascular Age-related Macular Degeneration with Subretinal Hemorrhage. Ophthalmology in Russia. 2025;22(4):811-820. (In Russ.) https://doi.org/10.18008/18165095-2025-4-811-820
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