Impact of fluorescein angiographic characteristics of macular lesions on outcomes after macular translocation 360° surgery in eyes with age-related macular degeneration

Purpose: To evaluate the relationship between preoperative lesion size and composition and visual outcomes at 1 year after macular translocation surgery with 360 degrees peripheral retinectomy (MT360) for neovascular age-related macular degeneration (AMD). Methods: A prospective, interventional, consecutive, noncomparative case series of 64 patients with bilateral neovascular AMD treated with MT360 in the eye with more recent vision loss. Masked reviewers graded preoperative fluorescein angiograms for lesion size in Macular Photocoagulation Study disk areas (MPS DAs) and predominant lesion composition (classic or occult choroidal neovascularization or subretinal hemorrhage). Median changes in distance and near visual acuities and reading speed at 12 months after surgery were analyzed with respect to lesion size and composition. Results: There was no significant difference between the outcomes for small-, medium- or large-sized preoperative lesions. Patients in each predominant lesion composition group had median improvement in visual outcomes with significant improvement in near visual acuity and reading speed for predominantly classic and occult lesions. Conclusion: MT360 stabilizes or improves visual function in patients with neovascular AMD irrespective of lesion size categories and with a variety of lesion compositions. Removal of the subretinal lesion and repositioning of the fovea over a healthier retinal pigment epithelial bed may account for these improvements.