Proof of Concept: Translocation and Transplantation in AMD
The principle of surgical treatment in AMD is that of cell rescue. This concept has been demonstrated following two surgical techniques in macular translocation surgery (MTS) and in autologous block transplantation.
Both these surgical techniques have shown that replacing the diseased cells restores vision thus providing proof of concept of this approach. We learnt that patients who had MTS within a 6-10 week window of sudden visual loss are more likely to benefit from surgery than those who presented later. Furthermore, patients who were able to target their fixation on a bright stimulus do better as they may have more viable photoreceptor cells to be rescued. Thus replacing diseased support cells can restore visual function, with some patients reading and re-gaining their driver’s licence. In contrast, in patients who only had removal of choroidal neovascular membrane without replacement of underlying RPE and choroid had very poor outcomes. The success is a proof of concept for transplantation.