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additional knowledge about the significance of autofluorescence in these patients is required. However, if further studies confirm that free graft translocation does prevent recurrent RPE atrophy, this treatment might not only be beneficial for the patients, but also revitalize discussions on the pathophysiology of dry AMD.

Summary for the Clinician

The translocation of a full-thickness graft usually results in a vascularized and functioning graft in patients with geographic atrophy.

A longer follow-up is necessary to learn about the long-term survival and functionality of the graft.

Acknowledgements

The authors acknowledge Sandra Joeres, MD; Florian Heussen, BS; and Nader Fawzy, BS for excellent patient follow-up.

References

1.Algvere PV, Berglin L, Gouras P, Sheng Y, Kopp ED. Transplantation of RPE in age-related macular degeneration: observations in disciform lesions and dry RPE atrophy. Graefes Arch Clin Exp Ophthalmol 1997;235:149–158.

2.Bellmann C, Jorzik J, Spital G, Unnebrink K, Pauleikhoff D, Holz FG. Symmetry of bilateral lesions in geographic atrophy in patients with agerelated macular degeneration. Arch Ophthalmol 2002;120:579–584.

3.Cahill MT, Mruthyunjaya P, Bowes Rickman C, Toth CA. Recurrence of retinal pigment epithelial changes after macular translocation with 360 degrees peripheral retinectomy for geographic atrophy. Arch Ophthalmol 2005;123:935–938.

4.Eckardt C, Eckardt U. Macular translocation in non-exudative age-related macular degeneration. Retina 2002;22:786–794.

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5.Holz FG, Bellman C, Staudt S, Schütt F, Völcker

HE. Fundus autofluorescence and development of geographic atrophy in age-related macular degeneration. Invest Ophthalmol Vis Sci 2001;42:1051–1056.

6.Joussen AM, Heussen FMA, Joeres S, Llacer H, Prinz B, Rohrschneider K, Maaijwee KJM, van Meurs J, Kirchhof B. Autologous translocation of the choroid and RPE in age related macular degeneration. Am J Ophthalmol 2006;142:17–30.

7.Joussen AM, Joeres S, Fawzy N, Heussen FMA, Llacer H, van Meurs J, Kirchhof B. Autologous translocation of the choroid and RPE in patients with geographic atrophy. Ophthalmology, accepted for publication.

8.Khurana RN, Fujii GY, Walsh AC, Humayun MS, de Juan E Jr, Sadda SR. Rapid recurrence of geographic atrophy after full macular translocation for nonexudative age-related macular degeneration. Ophthalmology 2005;112:1586–1591.

9.Kim SY, Sadda S, Humayun MS, de Juan E Jr, Melia BM, Green WR. Morphometric analysis of the macula in eyes with geographic atrophy due to age-related macular degeneration. Retina 2002;22:464–470.

10.Lappas A, Weinberger AWA, Foerster AMH, Kube T, Kirchhof B. Iris pigment epithelium translocation in age related macular degeneration. Graefes Arch Exp Clin Ophthalmol 2000;238:631–641.

11.Lappas A, Foerster AM, Weinberger AW, Coburger S, Schrage NF, Kirchhof B. Translocation of iris pigment epithelium in patients with exudative age-related macular degeneration: longterm results. Graefes Arch Clin Exp Ophthalmol 2004;242:638–647.

12.Owen CG, Fletcher AE, Donoghue M, Rudnicka AR. How big is the burden of visual loss caused by age related macular degeneration in the United Kingdom? Br J Ophthalmol 2003;87:312–317.

13.Peyman GA, Blinder KJ, Paris CJ, Alturki W, Nelson NC, Desai U. A technique for retinal pigment epithelium transplantation for age-related macular degeneration secondary to extensive subfoveal scarring. Ophthalmic Surg 1991;22:102.

14.Schatz H, Mc Donald R. Atrophic macular degeneration: rate of spread of geographic atrophy and visual loss. Ophthalmology 1989;96:1541–1551.

152 Autologous Translocation of the Choroid and RPE in Patients with Geographic Atrophy

15.Schmitz-Valckenberg S, Bultmann S, Dreyhaupt J, Bindewald A, Holz FG, Rohrschneider K. Fundus autofluorescence and fundus perimetry in the junctional zone of geographic atrophy in patients with age-related macular degeneration. Invest Ophthalmol Vis Sci 2004;45:4470–4476.

16.Scholl HP, Bellmann C, Dandekar SS, Bird AC, Fitzke FW. Photopic and scotopic fine matrix mapping of retinal areas of increased fundus autofluorescence in patients with age-related maculopathy. Invest Ophthalmol Vis Sci 2004;45:574–583.

17.Stanga PE, Kychenthal A, Fitzke FW, Halfyard AS, Chan R, Bird AC, Aylward GW. Retinal pigment epithelium translocation after choroidal neovascular membrane removal in age-re- lated macular degeneration. Ophthalmology 2002;109:1492–1498.

18.Sunness JS, Gonzales-Baron J, Applegate CA, et al. Enlargement of atrophy and visual acuity loss in the geographic atrophy form of agerelated macular degeneration. Ophthalmology 1999;106:1768–1779.

19.Thumann G, Aisenbrey S, Schraermeyer U, et al. Transplantation of autologous iris pigment epithelium after removal of choroidal neovascular membranes. Arch Ophthalmol 2000;118:1350–1355.

20.Van Meurs JC. Retinal pigment epithelium and choroid translocation in patients with exudative age-related macular degeneration. In: Kirchhof B, Wong D (eds) Essentials of ophthalmology: vitreoretinal surgery. Springer, Berlin Heidelberg New York, 2005; pp 73–87.

21.Van Meurs JC, Van Den Biesen PR. Autologous retinal pigment epithelium and choroid translocation in patients with exudative age-related macular degeneration: short-term follow-up. Am J Ophthalmol 2003;136:688–695.

22.Weisz JM, Humayun MS, De Juan E Jr, Del Cerro M, Sunness JS, Dagnelie G, Soylu M, Rizzo L, Nussenblatt RB. Allogenic fetal retinal pigment epithelial cell transplant in a patient with geographic atrophy. Retina 1999;19:540–545.

12

Subject Index

20-gauge vitreous cutter

102

 

B

 

 

– biopsy 109

 

 

25-gauge vitrectomy

 

 

 

 

ciliary body tumors 102

 

 

 

 

 

system 85, 89

 

 

 

B-scan ultrasonography 101

 

ciliary melanomas 110

25-gauge vitrectomy

 

bacillus species 56

 

 

ciprofloxacin

72

 

 

technique 99

 

 

bacteria 79

 

 

Cloque’s canal

116

 

5-fluorouracil (5FU) 33, 34

bacterial exotoxins

80

 

coagulase-negative

 

 

 

 

 

best corrected visual acuity

 

staphylococci

74

 

 

 

 

 

(BCVA) 21

 

 

conjunctiva 86, 89

 

 

 

 

 

binocular indirect

 

 

conjunctival chemosis 71

A

 

 

 

 

 

 

ophthalmomicroscope

 

contact lens 46, 93

 

 

 

 

 

 

 

abscess removal 75

 

 

(BIOM) 46, 92

 

 

cornea 60

 

 

 

absent red reflex

71

 

 

blood–retinal barrier

 

corneal edema 71

 

achromobacter

 

 

 

breakdown 34

 

 

corneal epithelium 59

xylosoxidans

79

 

 

Bruch’s membrane

146, 150

 

corticosteroids 66

 

age-related macular

 

 

 

 

 

cryotherapy 137, 138, 145

degeneration (AMD)

143

 

 

 

 

crystalline lens 46, 61

air–fluid exchange 44

 

 

 

 

 

cystoid macular edema 56,

 

 

C

 

amelanotic melanoma 109

 

 

138

 

 

 

 

 

 

 

 

 

amyloidosis 117

 

 

 

capsulectomy 54, 61

 

 

 

 

 

anterior chamber 60

 

cataract 7, 13

 

 

 

 

 

 

antibiotics 66

 

 

cataract extraction

56

 

 

 

 

 

 

 

 

D

 

 

 

antibiotics sensitivity

 

cataract surgery 69, 70, 75, 80

 

 

 

 

 

 

 

 

 

 

testing 74

 

 

cefazolin 72

 

 

daunomycin 37

 

 

anticoagulants 145

 

 

ceftazidime 76, 79

 

 

Densiron 22, 26

 

 

aphakia 138

 

 

 

chandelier system

91

 

Densiron-68 24

 

 

aspiration vacuum 87

 

 

chorio-retinopathy

11

 

Descemet’s folds

60, 61

aspirin 145

117

 

 

choriocapillaris 144, 148

 

detached retina

61, 63

asteroid hyalosis

 

 

chorioretinal scar 126

 

diabetes mellitus

70, 79

atrophic holes 136

 

 

choroidal atrophy

144

 

diabetic retinopathy

96

atrophy 143, 146, 148

 

 

choroidal detachment 72

 

dialyses 134

 

 

 

autologous platelet concentrate

 

choroidal hemangiomas 99

 

disomy 3 melanomas

110

(APC) 9

 

 

 

choroidal melanomas 99, 110,

 

 

 

 

 

autologous serum 9

 

113

 

 

 

 

 

 

autologous whole blood

 

choroidal metastasis 107

 

 

 

 

 

 

 

E

 

 

 

(AWB) 24

 

 

 

choroidal neovascularization

 

 

 

 

 

 

 

 

(CNV) 146, 150

 

Early Treatment Diabetic

 

 

 

 

choroidal nevi 99

 

 

Retinopathy Study

 

 

 

 

choroidal tumor 99, 108, 109

 

(ETDRS) 145

 

154

Subject Index

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

echography 101

 

 

 

fundus autofluorescence

147

inflammatory debris load 59

 

edema 59

 

 

 

 

fundus autofluorescence

 

 

inner limiting membrane

 

EIBOS 46

 

 

 

 

imaging 5

 

 

 

(ILM) 10, 19, 95

 

 

elimination of aqueous 48

 

fundus controlled

 

 

indocyanine green (ICG)-

 

emmetropic eyes

116

 

perimetry

150

 

 

 

 

assisted

95

 

 

 

endo-illumination 90

 

fundus fluorescein

 

 

peeling

10

 

 

 

 

endo-laser 130

53, 54, 55, 56,

 

angiography 5

148

inner limiting membrane

 

endophthalmitis

 

fundus microperimetry

 

 

peeling

11

 

 

 

 

 

57, 58, 62, 67, 69

 

 

 

 

 

 

 

technique

11

 

 

 

 

maculopathy

55

 

 

 

 

 

 

 

 

intracameral adrenalin

61

 

 

organisms

56

 

 

 

 

 

 

 

 

intraocular bacteria 70

 

 

 

 

 

G

 

 

 

 

 

 

vitrectomy for

58

 

 

 

 

 

 

intraocular gas bubble

127

 

 

 

 

 

 

 

 

 

 

Endophthalmitis Vitrectomy

 

gas tamponade 6, 64

 

 

intraocular lymphomas 110

 

 

 

Study (EVS) 56, 58, 75

 

gram-positive bacteria 72

 

intraocular pressure 13, 48

 

 

endotamponade 41

 

 

gram-positive

 

 

 

intraocular tamponade 8

 

endotoxin 53

 

 

 

 

staphylococci 74

 

 

intraocular trauma

37

 

 

enterococcus

 

 

 

 

granulocytes

74

 

 

intraocular tumor

101

 

 

 

 

endophthalmitis 73

 

 

 

 

 

 

intraocular tumor biopsy 104

 

 

enterococcus faecalis

79

 

 

 

 

 

 

intraretinal cyst 3

 

 

 

enucleation 110

 

 

 

 

 

 

 

 

intraretinal schisis

3

 

 

 

 

 

H

 

 

 

 

 

 

enzyme 53

 

 

 

 

 

 

 

 

intravitreal antibiotics

80

 

 

 

 

 

 

 

 

 

 

 

epiretinal membranes 19

 

haemophilus influenzae

79

Invertertube 93, 94

 

 

 

peeling 19

 

 

 

halogen light source 92

 

 

iridocyclectomy 102

 

 

 

ETDRS acuity 7

 

 

Hartmann’s solution 35

 

 

iris melanomas 105

 

 

exotoxin 53, 69

 

 

 

heavier-than-water

 

 

iris tumors

102, 103, 105

 

eyelid chemosis 71

 

 

endotamponade 20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

heavier than water silicone oil

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(HSO) 22, 25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

L

 

 

 

 

 

 

 

F

 

 

 

 

– removal 25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

hemorrhage

60, 67, 105

 

 

lacuna formation 116

 

 

 

 

 

 

 

 

 

 

 

 

 

fibrin 34

 

 

 

 

heparin 35

116

 

 

laser demarcation

137

20, 136

 

fibronectin 35

 

 

 

high myopia

134

laser photocoagulation

 

fine needle aspiration biopsy

 

horseshoe-shaped tears

laser retinopexy 138

 

 

 

 

(FNAB) 102

 

 

 

hyaluronidase 76

 

 

lensectomy 61

 

 

 

 

floaterectomy

117

 

 

hydrodissection 145

 

 

light pipe 87, 91

 

 

 

floaters 116

 

 

 

 

hyperfluorescence 5

 

 

lipofuscin pigment

99

 

 

fluid–air exchange 25, 43

 

hypopyon 71, 81

 

 

long-term tamponade

131

 

fluorescein angiography 101,

 

 

 

 

 

 

loose debris 60

 

 

 

 

 

149

 

 

 

 

 

 

 

 

 

low molecular weight heparin

 

Fluoron 24

 

 

 

 

 

 

 

 

 

 

 

(LMWH) 33

 

 

 

 

72

 

 

I

 

 

 

 

 

 

 

 

 

 

fluoroquinolone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Foerster cross

148

 

 

immunosuppression 70

 

 

 

 

 

 

 

 

 

 

 

forceps 88, 89

 

 

 

 

indirect ophthalmoscopy

46,

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

M

 

 

 

 

 

 

fovea centralis

 

 

118

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

foveal retinal pigment

indocyanine green (ICG)

11,

macula detachment 45

 

 

 

epithelium (RPE)

20

24

 

 

 

 

macular hole

1, 2, 3, 4, 13, 19

 

 

free autologous graft

146

 

indocyanine green (ICG)-

 

full-thickness hole 3

 

 

autofluorescence 146

 

staining of ILM 95

 

 

impending

2

 

 

 

 

free graft 145

 

 

 

 

inferior breaks

125

 

 

occult hole

3

 

 

 

 

free graft translocation 150

 

inferior retina

126

 

 

spontaneous regression 4

 

 

 

 

Subject Index

155

surgery 19

surgery system

pseudomonas aeroginosa 79

 

visual recovery 13

(OFFISS)

92, 94

pseudophakia 138

 

macular hole (MH) surgery 95

orbital tumor

102

pseudophakic retinal

 

macular hypopyon

55, 57, 59

 

outpatient fluid–gas exchange

 

detachment 126

macular pucker 37

 

(FGEX) 20

 

 

pus accumulation 63

macular translocation 96

 

overfilling the eye 48

 

 

 

 

 

malignant neoplasms 105

Oxane HD 21, 22, 27, 28

 

 

 

 

matrix metalloproteinases

 

 

 

 

 

 

 

 

 

 

 

 

 

R

 

 

(MMPs) 34

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

mean fixation point

 

P

 

 

 

Radner test

144, 148

(MFP)

148

 

 

 

 

 

 

retinal atrophy

144

 

 

 

 

 

 

 

melanoma

101, 104, 105, 108

 

“proportional pars plana

 

retinal breaks

125

mepivacaine 76

 

 

vitrectomy” [PPPV]

60

 

retinal detachment 36, 37, 43,

metamorphopsia 4

 

pain 71

 

 

65, 134

 

 

metastasis

104

 

 

panophthalmitis 64

 

 

retinal fold

44, 45, 48

microperimetry 150

paracentral scotomata

10, 11

 

retinal pigment epithelial

microplasmin

96

 

pars plana vitrectomy

 

 

(RPE) cells

34

micropsia

4

 

 

 

(PPV) 10, 19, 24, 75, 79, 85,

 

retinal pigment

microvitreoretinal blade 90

118, 120, 126, 140

 

 

epithelium

137, 143

monosomy 3 110

 

 

– instruments 85

 

 

retinoblastoma 113

Moorfields Macular Hole

 

penetrating trauma 33

 

 

retinopexy

13, 130, 136

Study (MMHS)

7

 

perfluorocarbon liquid

 

 

retinoschisis 129, 134

mouches volantes

115, 116

 

(PFCL) 42, 44, 49, 96, 129

 

retinotomy

41, 109, 145

Muller cell

2

 

 

 

perfluorohexyloctane

 

 

retrobulbar block 104

multicystic iridociliary

 

(F6H8) 20, 44, 96

 

 

rhegmatogenous retinal

tumor 103

 

 

 

perfluoropropane gas 8

 

detachment (RRD) 109,

myopia 1, 14, 136

 

peripheral nasal–visual field

125, 128, 133, 134

 

 

 

 

 

defects 12

 

 

 

rheopheresis 145

 

 

 

 

 

peripheral vitrectomy 8

 

ruthenium plaque 104

 

 

 

 

persistent subfoveal

 

 

ruthenium plaque

N

 

 

 

 

 

 

 

 

detachment 140

 

 

brachytherapy 111

National Eye Institute Visual

 

personality traits 121

 

 

 

 

 

Function Questionnaire

phacoemulsification 61, 79

 

 

 

 

(NEIVFQ-39) 121

photocoagulation 145

 

 

 

 

 

 

 

S

 

 

Nd:YAG vitreolysis 120

phototoxic injury 12

 

 

 

 

 

 

 

 

 

necrosis 63, 71

 

 

plasmin 96

 

137

 

“subclinical retinal

– of the retina 71

 

 

pneumatic retinopexy

 

detachment” (SCRD) 133

neo-macula 144

 

 

post-vitrectomy fibrin

 

 

“Sutureless” wounds 89

neodym-YAG laser 120

 

formation 35

 

 

scissors 88

 

 

nevus 108

 

 

 

 

posterior capsulorhexis 117

 

sclera 86, 89

 

nuclear sclerosis 119

posterior hyaloid 19

 

 

scleral buckle

136

 

 

 

 

 

posterior vitreous detachment

 

scleral buckling 36, 138, 140

 

 

 

 

 

(PVD) 59, 116

 

 

sclerotomy

46, 48, 105, 129

 

 

 

 

 

prednisolone

76

 

 

scotoma 4, 148

O

 

 

 

 

 

 

 

 

pressure plate

88

 

 

septicemia

55

 

 

 

 

 

 

 

 

 

ocular redness

71

 

 

proliferative vitreoretinopathy

 

Serratia 56

 

 

opaque media

72

 

 

(PVR) 33, 126, 129, 144

 

sickle cell retinopathy 119

optical coherence tomography

 

Proteus 56

 

 

 

silicone oil

42, 46, 48, 65, 96

(OCT)

1, 6, 23, 139

 

pseudoholes 5

 

 

– injection

48

optical fiber-free intravitreal

 

Pseudomonas

56

 

 

silicone oil exchange 35

156

Subject Index

 

 

 

 

 

 

 

 

 

 

 

 

 

 

silicone oil tamponade

8, 20

 

transparent eye model

Vitrectomy for Prevention of

 

slippage 41, 46

 

 

chamber 47

 

 

 

Macular Hole (VPMH) 6

 

slitlamp biomicroscopy

118

 

trauma 1

 

 

 

vitreo-foveal traction

2

 

 

Snellen acuity 7

 

 

triamcinolone 62

 

vitreoretinal interface

12

 

 

Snellen visual acuity 121

 

triamcinolone acetonide

vitreoretinopathy

13, 96

 

 

staphylococcus 56

 

 

(TA) 24, 95

 

 

vitreoschisis 59

 

 

 

 

 

staphylococcus aureus

72, 79

 

trocar 86

 

 

 

vitreous cavity

42, 47, 76, 137

 

staphylococcus epidermidis

 

trocar system

85

 

vitreous cutter

86, 90

 

 

 

 

endophthalmitis 73

 

 

trypan blue dye

12

 

vitreous detachment

125

 

 

 

streptococcus species 56

 

tumor enlargement

110

vitreous floaters 115

35, 64

 

 

subclinical retinal detachment

 

 

 

 

 

vitreous hemorrhage

 

 

 

(SCRD) 134

 

 

 

 

 

 

vitreous opacity 116, 121, 138

 

 

subretinal fluid 44, 45, 133,

 

 

 

 

 

vitreous separation

62

 

 

 

 

U

 

 

 

 

 

137, 139

 

 

 

 

 

vitreous syneresis

125

 

 

 

 

 

 

 

 

 

 

 

sulfahexafluoride 8

 

 

ultrasonography

57

 

vitritis 71

 

 

 

 

 

 

systemic antibiotics 58

 

 

uveal lymphoma

112

 

 

 

 

 

 

 

 

 

 

 

 

uveal tumor biopsy 99

 

 

 

 

 

 

 

 

 

 

 

 

uveal tumors 100

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

W

 

 

 

 

 

 

 

T

 

 

uveitis 81, 119

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

uveitis, vitreous

 

 

warfarin 145

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

tamponade agent 127, 130

 

haemmorhage 117

Watzke-Allen slit beam test

5

 

tantalum markers 104, 105

 

uveitis anterior 71

 

Weiss ring 4

 

 

 

 

46,

 

temporary keratoprosthesis

 

 

 

 

 

wide-angle viewing system

 

 

(TKP) 60

 

 

 

 

 

 

92

 

 

 

 

 

 

 

Tenon’s capsule fibroblasts 35

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

V

 

 

 

 

 

 

 

 

 

 

 

tetracaine 76

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TGF-β2 9

 

 

vancomycin 76, 79

 

 

X

 

 

 

 

 

 

– nonbovine 9

 

 

Van de Waal’s forces

42

 

 

 

 

 

 

 

34

 

 

 

 

 

 

 

 

 

 

thymidylate synthetase

 

vasculitis 119

 

 

xanthophyll pigment

4

 

 

tissue inhibitors of

 

 

viscoelastics

61

 

 

xenon illumination

92

 

 

 

metalloproteinases

 

 

visual acuity

3, 4, 140

– with yellow filter

92

 

 

 

(TIMPs) 34

 

visual acuity testing

115

xenon light source

87, 91

 

 

 

tissue melting 64

 

visual field defects 13, 95

 

 

 

 

 

 

 

 

topical corticosteroid

 

 

Visual Function Index

 

 

 

 

 

 

 

 

 

therapy 64

 

 

(VF-14) 121

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Z

 

 

 

 

 

 

 

trabeculectomy 56

 

 

visual loss 71, 81

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

transforming growth factor-

 

vitamin substitution

145

Zeiss microscope

93

 

 

 

 

beta 2 (TGF-β2) 9

 

 

vitrectomy 6, 36

 

 

 

 

 

 

 

 

 

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