Alignment of Neurosensory Layers May Predict Autologous Retinal Transplant Success

Retinal Detachment, Surgery
Ophthalmology surgery, Pasteur 2 Hospital, Nice, France, treatment of a retinal detachment through vitrectomy, The doctor is helped by the intern. (Photo by: BSIP/Universal Images Group via Getty Images)
Researchers identify positive prognostic indicators following autologous retinal transplantation.

This article is part of Ophthalmology Advisor’s Focus on Retina coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the retinal experts at the AAO. Check back for more from the AAO 2021 Meeting.


Following autologous retinal transplantation (ART), features of graft integration may serve as positive prognostic indicators of functional outcomes, according to research presented at the American Academy of Ophthalmology meeting, held November 12-15 in New Orleans. In particular, the presenters reported that alignment of neurosensory layers could be used as an early sign of success, while undersized grafts and turbulence during fluid-air exchange could elevate the risk of graft dislocation.

Researchers in this multicenter, retrospective study, examined the results of 130 ART surgeries performed by 33 surgeons treating primary and refractory macular holes (MHs) and MH-retinal detachments. Of the procedures assessed, closure rate was 89% for all cases with a mean follow-up of 8.6± 0.8 months. Alignment of neurosensory layers was noted in 16% of cases and was indicative of better final vision (P =.01). Graft positioning was also significantly associated with reaching alignment of neurosensory layers, (P =.039). 

Graft integration was likely whenever a vertical striation line was identified between the graft and host retina on optical coherence tomography (OCT) at postoperative day 1 and week 1, and resolved by postoperative weeks 2 to 8, according to the study. 

Overall, 5 cases (3.8%) of graft dislocation were identified in which fluid-air exchange was conducted. Researchers concluded that alignment of neurosensory layers can be regarded as a positive prognostic indicator of ART functional success. In addition to undersized grafts and turbulence during fluid-air exchange, poor adherence to postoperative activity restrictions was considered a negative prognostic indicator, and suggestive of a higher risk of graft dislocation. 

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Moysidis SN, Koulisis N, Adrean S,  Charles ST, Chhablani JK, Cisneros J, et al. Graft alignment, integration and dislocation: the autologous retinal transplantation global consortium; Paper presented at American Academy of Ophthalmology 2021; November 12-15; New Orleans. PA063