Visual Outcomes Following Macular Translocation With 360° Peripheral Retinectomy

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Abstract
Objective To evaluate visual outcomes following macular translocation with 360° peripheral retinectomy in patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration. Methods In a prospective study, 15 consecutive patients with large subfoveal choroidal neovascularization underwent macular translocation with 360° peripheral retinectomy and silicone oil tamponade. Preoperative and postoperative photographs and fluorescein angiograms were obtained to evaluate lesion size and characteristics and translocation results. Standardized near and distance visual acuity and reading speed were measured preoperatively and 6 and 12 months postoperatively. Main Outcome Measures Changes in and final levels of near and distance visual acuity and reading speed. Results Median lesion size was 9 Macular Photocoagulation Study disc areas (range, 4-16 disc areas). In all patients, the fovea was successfully translocated off the subfoveal lesion. The median near visual acuity logMAR score (logarithm of the minimum angle of resolution) improved significantly from 0.54 units to 0.40 units (Snellen equivalent, 20/70 to 20/50; P =.02) at the 6-month follow-up and stabilized at 0.54 (12 months postoperatively; Snellen equivalent, 20/70). Seven (54%) of 13 patients and 7 (58%) of 12 patients achieved reading speeds of 70 words/min or greater at the 6-month and 12-month postoperative visits, respectively. Median preoperative distance visual acuity(20/100) was maintained at both the 6-month and 12-month examinations. No postoperative retinal detachments occurred in this series. Conclusion Macular translocation with 360° peripheral retinectomy and silicone oil tamponade stabilizes and can sometimes improve near and distance visual acuity and reading speed in patients with vision loss from subfoveal neovascular age-related macular degeneration.

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