Modified autologous neurosensory retinal transplantation and bevacizumab injection in primary extra-large chronic macular holes
Purpose: To investigate the outcome of primary idiopathic extra-large full-thickness macular holes (FTMH) treated with a modified autologous neurosensory retinal transplantation (ART) adjuncted by bevacizumab (BCZ) injection. Methods: In this retrospective interventional case series, five consecutiv...
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Elsevier
2025-06-01
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| Series: | American Journal of Ophthalmology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993625000222 |
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| author | Hossein Ashraf Sezaneh Haghpanah Mohammad Hossein Nowroozzadeh |
| author_facet | Hossein Ashraf Sezaneh Haghpanah Mohammad Hossein Nowroozzadeh |
| author_sort | Hossein Ashraf |
| collection | DOAJ |
| description | Purpose: To investigate the outcome of primary idiopathic extra-large full-thickness macular holes (FTMH) treated with a modified autologous neurosensory retinal transplantation (ART) adjuncted by bevacizumab (BCZ) injection. Methods: In this retrospective interventional case series, five consecutive patients with primary extra-large chronic FTMHs were investigated. The ART procedure included internal limiting membrane (ILM) peeling of both donor and macular hole (MH) areas, placement of the harvested tissue under the edges of MH and use of silicone oil tamponade. Results: The median age was 64 (60–77) years. The first patient developed choroidal neovascularization one month after surgery, which was treated with BCZ injections. Subsequent patients received injection of BCZ (1.25 mg/0.05 mL) into the silicone oil at the end of the initial surgery. At the last follow-up, complete anatomical closure of the MH was achieved in all patients. With the exception of the first patient, all other patients achieved either a final ellipsoid zone (EZ) defect of zero (three cases) or a reduction to 100 μm (one case). The external limiting membrane (ELM) was completely reconstructed in all of patients. All patients demonstrated an improvement in best corrected distant visual acuity (BCDVA) one month after ART surgery, which was sustained throughout the follow-up period (12–42 months). The median LogMAR BCDVA at baseline was 1.4 (1.3–1.4) which decreased to 1.1(1.0–1.1) (P = 0.041) at the first month and 1.0 (0.7–1.2) (P = 0.043) at the last follow-up. Conclusions: The use of ART surgery accompanied by BCZ injection appears to be an effective method for primary extra-large chronic FTMHs. |
| format | Article |
| id | doaj-art-54e434c7754541119cf9bf0cc28b7219 |
| institution | Kabale University |
| issn | 2451-9936 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj-art-54e434c7754541119cf9bf0cc28b72192025-02-12T05:31:29ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362025-06-0138102269Modified autologous neurosensory retinal transplantation and bevacizumab injection in primary extra-large chronic macular holesHossein Ashraf0Sezaneh Haghpanah1Mohammad Hossein Nowroozzadeh2Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Ophthalmology Department, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; Corresponding author. Poostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IranPoostchi Ophthalmology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Ophthalmology Department, Khalili Hospital, Shiraz University of Medical Sciences, Shiraz, IranPurpose: To investigate the outcome of primary idiopathic extra-large full-thickness macular holes (FTMH) treated with a modified autologous neurosensory retinal transplantation (ART) adjuncted by bevacizumab (BCZ) injection. Methods: In this retrospective interventional case series, five consecutive patients with primary extra-large chronic FTMHs were investigated. The ART procedure included internal limiting membrane (ILM) peeling of both donor and macular hole (MH) areas, placement of the harvested tissue under the edges of MH and use of silicone oil tamponade. Results: The median age was 64 (60–77) years. The first patient developed choroidal neovascularization one month after surgery, which was treated with BCZ injections. Subsequent patients received injection of BCZ (1.25 mg/0.05 mL) into the silicone oil at the end of the initial surgery. At the last follow-up, complete anatomical closure of the MH was achieved in all patients. With the exception of the first patient, all other patients achieved either a final ellipsoid zone (EZ) defect of zero (three cases) or a reduction to 100 μm (one case). The external limiting membrane (ELM) was completely reconstructed in all of patients. All patients demonstrated an improvement in best corrected distant visual acuity (BCDVA) one month after ART surgery, which was sustained throughout the follow-up period (12–42 months). The median LogMAR BCDVA at baseline was 1.4 (1.3–1.4) which decreased to 1.1(1.0–1.1) (P = 0.041) at the first month and 1.0 (0.7–1.2) (P = 0.043) at the last follow-up. Conclusions: The use of ART surgery accompanied by BCZ injection appears to be an effective method for primary extra-large chronic FTMHs.http://www.sciencedirect.com/science/article/pii/S2451993625000222Autologous retinal graftAutologous retinal transplantationBevacizumabMacular holeRetinal autograft |
| spellingShingle | Hossein Ashraf Sezaneh Haghpanah Mohammad Hossein Nowroozzadeh Modified autologous neurosensory retinal transplantation and bevacizumab injection in primary extra-large chronic macular holes American Journal of Ophthalmology Case Reports Autologous retinal graft Autologous retinal transplantation Bevacizumab Macular hole Retinal autograft |
| title | Modified autologous neurosensory retinal transplantation and bevacizumab injection in primary extra-large chronic macular holes |
| title_full | Modified autologous neurosensory retinal transplantation and bevacizumab injection in primary extra-large chronic macular holes |
| title_fullStr | Modified autologous neurosensory retinal transplantation and bevacizumab injection in primary extra-large chronic macular holes |
| title_full_unstemmed | Modified autologous neurosensory retinal transplantation and bevacizumab injection in primary extra-large chronic macular holes |
| title_short | Modified autologous neurosensory retinal transplantation and bevacizumab injection in primary extra-large chronic macular holes |
| title_sort | modified autologous neurosensory retinal transplantation and bevacizumab injection in primary extra large chronic macular holes |
| topic | Autologous retinal graft Autologous retinal transplantation Bevacizumab Macular hole Retinal autograft |
| url | http://www.sciencedirect.com/science/article/pii/S2451993625000222 |
| work_keys_str_mv | AT hosseinashraf modifiedautologousneurosensoryretinaltransplantationandbevacizumabinjectioninprimaryextralargechronicmacularholes AT sezanehhaghpanah modifiedautologousneurosensoryretinaltransplantationandbevacizumabinjectioninprimaryextralargechronicmacularholes AT mohammadhosseinnowroozzadeh modifiedautologousneurosensoryretinaltransplantationandbevacizumabinjectioninprimaryextralargechronicmacularholes |