Neovascular age-related macular degeneration (AMD) is a common cause of blindness among the elderly. Abnormal blood vessels grow underneath the center of the retina (the macula), leading to rapid visual loss. The standard treatment is intravitreal injections. If injections are not beneficial, surgery, e.g. retinal pigment epithelium (RPE) - choroid transplantation or macular translocation, can be an option in selected cases.
In RPE-choroid transplantation, the abnormal blood vessels under the macula are surgically removed. Due to iatrogenic trauma during removal of these blood vessels, the RPE underneath the macula gets damaged. The macula cannot function without RPE, and so the vision cannot improve. Therefore, a graft of RPE and choroid is transplanted from the periphery to the macula after the removal of the neovascularization.
A few patients that underwent RPE-choroid transplantation developed an inflammatory destructive reaction after uncomplicated surgery. The aim of the present study is to investigate the role of autoantibodies in these patients. For comparison, we include patients who did not develop an inflammatory reaction after RPE-choroid transplantation, AMD patients that underwent macular translocation, AMD patients treated with injections, and patients without AMD.
In recent years, stem cell therapy is being developed for various diseases. If there would be a stem cell treatment for AMD, the surgery could be safer, easier and would probably be carried out more frequently. Therefore, we expect inflammatory reactions as seen in our patients to occur more often in the future. For this reason, it is important to discover the cause of the inflammation and the role of autoantibodies in this process.
This research project is executed by the Rotterdam Eye Hospital (Rotterdam, The Netherlands) in collaboration with the department of ophthalmology and immunology of the Erasmus Medical Center (Rotterdam, the Netherlands) and the department of ophthalmology of the hospital Sacro Cuore – Don Calabria (Verona, Italy).
Start: June 2020, finish: March 2021