PhD defence S.H.M. (Saskia) van Romunde

Surgical Treatment for Exudative Age-related Macular Degeneration

Prof.dr. J.C. van Meurs


Drs. G. Pertile

Thursday 26 Jan 2023, 10:30 - 12:00
PhD defence
Senate Hall
Erasmus Building
Campus Woudestein
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S.H.M. van Romunde will defend her PhD dissertation on Thursday 26 January 2023, entitled: ’Surgical Treatment for Exudative Age-related Macular Degeneration‘.


Background: Submacular surgery for exudative age-related macular (AMD, i.e. full macular translocation (FMT) and retinal pigment epithelium (RPE-) choroid transplantation, is reserved for cases that do not benefit from standard treatment. The aim of this thesis was to study the long-term results of both surgical interventions, the morphological changes after FMT, and a potential immune response after RPE-choroid transplantation. 

Results: A retrospective study regarding FMT including 158 patients with a mean follow-up of 45 months showed a significant visual gain five years postoperatively. A retrospective study of 81 patients that underwent RPE-choroid transplantation with a mean follow-up of 38 months showed a ≥3 line improvement in 53% of the patients after one year, and in 46% at last visit. Morphological change after FMT was evaluated in 51 patients with a mean follow-up of 30 months. The visibility of the external limiting membrane (ELM) increased in 29%. The most important predictive factors for a favourable outcome was the presence of ELM. Five patients had a destructive inflammatory reaction after uncomplicated RPE-choroid transplantation. When testing for RPE-antibodies, we found no evidence for an auto-immune origin. 

Conclusion: After submacular surgery, some of the morphology and function can be restored. Extrafoveal RPE seems to be able to sustain the fovea, also in the long-term. The most important predictive factor for surgical outcome is the integrity of the ELM. We observed five cases of inflammatory reaction after RPE-choroid transplantation, even though the graft was autologous. However, we were unable to pinpoint what elicited this reaction.

More information

The public defence will begin exactly at 10.30 hrs. The doors will be closed once the public defence starts, latecomers may be able to watch on the screen outside. There is no possibility of entrance during the first part of the ceremony. Due to the solemn nature of the ceremony, we recommend that you do not take children under the age of 6 to the first part of the ceremony.

A live stream link has been provided to the candidate.

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