Translocation of the macula for management of subfoveal choroidal neovascularization: comparison of results in age-related macular degeneration and degenerative myopia.

PURPOSE: To report the results of limited macular translocation in subfoveal choroidal neovascularization resulting from age-related macular degeneration or degenerative myopia.

METHODS

The first consecutive 32 patients (23 age-related macular degeneration eyes and nine myopic eyes) were operated on with the limited macular translocation technique described by de Juan. Before and after surgery, a complete examination included fluorescein and indocyanine-green angiographies and optical coherence tomography. Mean follow-up was 9 months in the age-related macular degeneration group (range, 6 to 14 months) and 10 months in the myopic group (range, 6 to 15 months).

RESULTS

The improvement in visual acuity was better in the myopic group than in the age-related macular degeneration group and was correlated with younger age in the myopic group (P <.05). At the end of follow-up, visual acuity improved by 2 lines or more in seven age-related macular degeneration eyes (30%), including four eyes (13%) with an improvement of 6 lines or more, and in six myopic eyes (67%), including two eyes (22%) with an improvement of 6 lines or more. Final visual acuity was unchanged in four age-related macular degeneration eyes (17%) and three myopic eyes (33%), and decreased in 12 age-related macular degeneration eyes (52%). Conversely, the mean foveal displacement was greater in age-related macular degeneration than in myopia (1,105 microm and 685 microm, respectively; P <.05). Main complications were retinal detachment (six eyes), neovascularization at the injection site (two eyes), and recurrence of neovascularization (43% of the age-related macular degeneration group and 11% of the myopic group).

CONCLUSIONS

Limited macular translocation allowed a significant improvement in visual acuity in some eyes with subfoveal neovascularization and resulted in a moderate rate of complications. Longer follow-up and additional studies are required to confirm these findings.