Results of limited macular translocation in subfoveal choroidal neovascularization in age-related macular degeneration

Purpose: Age-related macular degeneration (AMD) is the major cause of legal blindness in industrialized countries. The exudative form could be responsible for severe visual loss. Recent therapeutic approaches are now available for treating subfoveal neovascularization. The purpose of this study was to evaluate the visual results obtained with macular translocation (MT) in subfoveal choroidal neovascularization due to AMD. Methods: A prospective nonrandomized review of 29 consecutive patients with subfoveal neovascularization attributable to AMD. Limited macular translocation with chorioscleral infolding based on the De Juan technique was performed. The mean follow-up was 14 months. Results: The mean age of the patients studied was 75 years. The mean initial visual acuity was 20/200, with of 59% of patients having worse than 20/200. The mean displacement of the fovea after translocation was 1,274 pm, and at 1 year, vision was grossly unchanged in comparison to baseline (mean final gain of 0.7 line). Postoperative complications observed were retinal detachment (17.2%), macular hole (13%) and macular fold (14%). No complication was seen in 55.2% of the operated eyes, which had a mean final gain of 3.25 ETDRS lines at 14 months of follow-up. in comparison to the photodynamic therapy (PDT) group of the TAP study, 48% of the MT group had a gain of 1 line or more versus 16% of the PDT group. Conclusion: MT may lead to a significant improvement in visual acuity. Further larger and controlled studies are required to evaluate MT in the treatment of subfoveal neovascularization.