Limited macular translocation for atrophic maculopathy.

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Abstract
MACULAR translocation was developed as a technique for moving the fovea relative to underlying choroidal neovascularization. This allows both the photocoagulation of formerly subfoveal choroidal neovascularization, while sparing the foveal center, and the repositioning of the fovea over healthier retinal pigment epithelium (RPE). Machemer and Steinhorst1 first reported success with this technique in 1993 by using a 360° retinotomy to translocate the macula. Later, de Juan et al2 and Pieramici et al3 used scleral shortening to perform limited macular translocation without the need for a 360° retinotomy. Others have confirmed this initial success using both techniques.4-7 This procedure has preserved and even improved visual acuity. Although the emphasis, to date, has been on using macular translocation to treat subfoveal choroidal neovascularization, this technique may possibly be useful for patients with atrophic macular disease that involves the fovea and affects foveal function. Atrophic macular disease is generally associated with underlying RPE atrophy, often with associated loss of choriocapillaris, and the loss of RPE is what often leads to the loss of photoreceptors and the development of central scotomas.8-10 Theoretically, macular translocation may be useful for treating atrophic macular disease by placing the fovea over healthier RPE, which could prevent the loss of photoreceptors and sustain foveal function. This article presents the results of limited macular translocation in both eyes of a patient with atrophic macular disease, presumed to be caused by pattern dystrophy, who had poor visual acuity for a prolonged period of time prior to the procedure.

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