2008-20: Continuation of anti-VEGF (bevacizumab/ranibizumab) versus RPE-choroid graft in the treatment of non-responders intravitreal anti-VEGF injections.
Standard treatment for patients with exudative age-related macular degeneration
(AMD) is intravitreal injection of anti-VEGF. Patients for whom this therapy probably does not help to improve prospects are initially treated with anti-VEGF because alternatives are not available. Recently, it has been shown that retinal pigment epithelium (RPE)-choroid graft translocation can stabilize or even improve visual acuity in patients with choroidal neovascular lesions of AMD for whom prospects are rather poor. In this randomized study, we investigated whether RPE-choroid graft translocation provides a better alternative to anti-VEGF medication for these AMD patients, determined as visual outcome and foveal function after (initiation of) treatment. Patients were randomized between an RPE-choroid graft and regular anti-VEGF treatment. Irrespective of study arm, blood was always surgically removed in patients with massive haemorrhage.
To improve the surgical technique, the study team worked in collaboration with the TU Delft on further development of tools for the displacement of the graft.