gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

RPE-Transplantation: Factors, results and perspectives

Meeting Abstract

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  • corresponding author F.G. Holz - Department of Ophthalmology, Universitäs of Bonn, Bonn

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSA.07.03

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Holz.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Neovascular age-related macular degeneration (AMD) has become the leading cause for severe visual loss in all industrialized nations. The lack of effective treatments has not only prompted research into key pathogenetic pathways but also the development of novel therapeutic strategies. Surgical excision of choroidal neovascularizations (CNV) is technically feasable but invariably associated with inadvertent removal of corresponding retinal pigment epithelium (RPE) and subsequent atrophy of the choriocapillaris, with the latter two layers being a prerequisite for normal photoreceptor function. To cover the RPE defect both heterologous and homologous RPE cell suspensions have been injected into the subretinal space. The lack of functional improvement has been attributed to various factors including RPE-cell dedifferentiation, failure of adherence to Bruch's membrane as well as development of a regular RPE-cell monolayer. Therefore, techniques for translocating intact autologous RPE cell sheets have been sought and preservation of foveal neurosensory functions has recently been succesfully demonstrated. Besides translocation of a full-thickness of a RPE/Bruch's membrane/choroid patch outside the macular area, superfluous choroidal tissue may be ablated intraocularly by the use of an excimer laser (EST, E xcimer Laser assisted RPE S heet T ranslocation) prior to translocation. cSLO fundus autofuorescence imaging may be helpful to identify suitable areas for extramacular excision of noncompromised RPE cell patches and for demonstrating viability of translocated RPE cells. Besides recent pharmacological approaches including anti-VEGF agents these surgical developments open new perspectives for patients with neovascular AMD.