Temporal Changes in the Retinal Pigment Epithelium–Bruch’s Membrane Complex Thickness After Autologous Retinal Transplantation in Myopic Eyes

Abstract

PURPOSE. To investigate the association between the thickness of the retinal pigment epithelium (RPE)–Bruch’s membrane (BM) complex and the development of retinal autograft edema as a postoperative complication following autologous retinal transplantation (ART). METHODS. This retrospective study examined data from 28 eyes of 28 patients (14 males, 14 females; mean age, 61.5 ± 19.8 years) who underwent ART and were followed for 1 year. The RPE–BM complex thickness was measured 2000 μm from the fovea using Image J software. Additionally, the graft blood flow was also evaluated by optical coherence tomography angiography and fluorescein angiography. RESULTS. Macular hole (MH) diameters ranged from 711.2 ± 251.9 μm to 1299.9 ± 333.0 μm, with MH closure achieved in all patients. RPE–BM complex thickness decreased by 4.17 μm at 6 months and 4.34 μm at 1 year, showing significant differences from preoperative measurements (29.88 ± 4.99 μm; 6 months: 95% confidence interval [CI], 1.62–6.71, P = 0.0018; 1 year: 95% CI, 2.03–6.65 μm, P = 0.00044). The decrease was significantly greater in the edema-positive group (95% CI, –8.33 to –0.82, P = 0.020). Furthermore, the rates of ellipsoid zone (EZ) recovery, alignment of neurosensory layers (ANL), and graft reperfusion were lower in the edema-positive group (EZ, P = 0.017; ANL, P = 0.0098; reperfusion, P = 0.039). CONCLUSIONS. After ART, RPE–BM complex thickness decreases, particularly in cases with postoperative edema, suggesting a potential relationship between RPE function and postoperative outcomes, highlighting the importance of monitoring RPE–BM complex thickness after surgery.