gms | German Medical Science

21st Annual Meeting of the German Retina Society and 8th Symposium of the International Society of Ocular Trauma (ISOT)

German Retina Society
International Society of Ocular Trauma

19.06. - 22.06.2008, Würzburg

Surgical Management of Subfoveal Choroidal Neovascular Membranes in Age Related Macular Degeneration by Macular Translocation - Experiences of an early stopped randomized clinical trial (MARAN Study)

Meeting Abstract

  • Antonia M. Joussen - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • D. Wong - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • P. Walter - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • B. Kirchhof - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • J. Dreyhaupt - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • C. Bauer - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • J. Munzinger - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • K. Unnebrink - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • A. Freiberger - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • M. Seibert-Grafe - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • N. Victor - Düsseldorf/Germany, Liverpool/UK, Aachen/Germany, Köln/Germany
  • MARAN study

Retinologische Gesellschaft. International Society of Ocular Trauma. 21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem 8. Symposium der International Society of Ocular Trauma. Würzburg, 19.-22.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocISOTRG2008V109

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/rg2008/08rg110.shtml

Published: June 18, 2008

© 2008 Joussen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Rationale: The MARAN trial was planned to assess the effectiveness of full macular translocation in patients with neovascular age-related macular degeneration and early stopped because of low recruitment.

Methods: Patients suffering from visual loss due to neovascular age related macular degeneration (ARMD) were randomized to either surgery or a control group receiving standard treatment (observation or photodynamic therapy). The primary endpoint was the change of visual acuity (ETDRS) at 52 weeks after randomization compared to initial visual acuity, secondary endpoints included reading performance, contrast sensitivity, stability of fixation, eye specific quality of life, and the absolute number of letters read correctly at 52 weeks after randomization compared to initial examination.

Results: A total of 28 patients were included into the study. The study shows no difference with respect to the visual outcome, nor any of the secondary outcomes measured. The study was complicated by the low recruitment what can be attributed to the difficulty in the decision between a major operation and conservative treatment, as well as the emerging new treatments for ARMD.

Conclusion: The results of this randomized clinical trial fail to demonstrate a superiority of surgery over observation or photodynamic therapy (PDT) in patients with exudative ARMD, perhabs due to the early stop. Still there is a trend that reading function is superior after surgery. In the light of the new pharmacological treatments surgical options such as macular translocation will be an option for only selected cases, however, the conclusions from this trial are limited by the small number of patients included.

Keywords: age-related macular degeneration – macular translocation – randomized clinical trial