Treatment of non-age-related macular degeneration submacular diseases with macular translocation surgery.

PURPOSE: To evaluate the use of macular translocation surgery 360 in blinding submacular diseases other than age-related macular degeneration. METHODS: A retrospective, consecutive case review was performed of subjects treated with macular translocation surgery 360 for a submacular disease other than age-related macular degeneration. Primary outcome was change in visual acuity. Clinical data were collected and analyzed, including demographics, visual acuity, imaging features, surgery details, and complications. RESULTS: The review identified 16 subjects who had undergone macular translocation surgery 360 from 1996 to 2009 for submacular diseases other than age-related macular degeneration. These diseases included Best disease (n = 2), angioid streaks (n = 1), pathologic myopia (n = 3), punctate inner choroidopathy (n = 2), presumed ocular histoplasmosis syndrome (n = 3), central serous chorioretinopathy (n = 1), adult-onset vitelliform macular dystrophy (n = 3), and North Carolina macular dystrophy (n = 1). Mean preop visual acuity was 20/135 (range, 20/50-20/500). A ≤ 3-line acuity loss was seen in 13 of 16 (81%) subjects. Mean postop visual acuity was 20/110 (range, 20/40-20/1,000). The most common postop complications included epiretinal membrane (50%), cystoid macular edema (31%), residual diplopia (25%), retinal detachment (13%), and recurrent choroidal neovascularization (13%). Mean follow-up was 28 months (range, 4-61 months). CONCLUSION: Macular translocation surgery 360 may be considered in subjects with progressive bilateral vision loss from various conditions other than age-related macular degeneration. Although a significant number of complications occurred, a large percentage of subjects gained >3 lines of visual acuity (38%) and achieved a final visual acuity of ≥ 20/50 (31%).

Duke Scholars

Author Ramiro Maldonado Ophthalmology, Vitreoretinal Diseases & Surgery

Author Cynthia Ann Toth Ophthalmology, Vitreoretinal Diseases & Surgery