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[Rheophoresis. A systematic approach to therapy of age-related macular degeneration (AMD)?]
A J Fell1, K Engelmann, G Richard
1Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Germany. fell@uke.uni-hamburg.de
Insights
Rheophoresis treatment improved visual acuity in some patients with age-related macular degeneration (AMD). Further studies are recommended to define rheophoresis indications for AMD.
Area of Science:
- Ophthalmology
- Microcirculation research
- Biomedical engineering
Context:
- Age-related macular degeneration (AMD) involves impaired choroidal microcirculation.
- Lipid and protein deposition in Bruch's membrane is characteristic of AMD.
- Rheophoresis offers a potential therapeutic approach by improving microcirculation.
Purpose:
- To analyze the effect of rheophoresis on visual acuity and drusen in patients with age-related macular degeneration (AMD).
Summary:
- Ten patients with early or late AMD received 10 rheophoresis treatments over 18 weeks.
- Visual acuity and color vision were assessed over 12 months; fluorescein angiography was performed.
- Improvements in visual acuity and reductions in drusen were observed in some patients.
Impact:
- Findings suggest rheophoresis may benefit AMD patients, aligning with previous trial data.
- Further multicentric studies are needed to refine rheophoresis indications for AMD.
- This research contributes to understanding microcirculation-focused therapies for AMD.
Background:
Choroidal microcirculation is impaired in age-related macular degeneration (AMD), and leads to deposition of lipids and proteins in Bruch's membrane. Rheophoresis can improve choroidal microcirculation by eliminating high molecular weight, rheologically relevant plasma proteins. The objective of this post-certification study was to analyse the effect of rheophoresis in 10 AMD patients.
Patients And Methods:
A total of 6 patients with early AMD and 4 with late AMD in one eye (initial visual acuity equivalent 0.2-0.8) received rheophoresis treatment 10 times over an 18-week period. Visual acuity and color vision were determined initially and after 3, 5 and 12 months and fluorescein angiography was performed.
Results:
Patients with early AMD showed improvement of visual acuity (2 lines on ETDRS charts) in 2 out of 6 cases and a stable visual acuity in 4 out of 6 cases 1 year after rheophoresis, whereas patients with late AMD showed improvement of visual acuity (2 lines on ETDRS charts) in 1 out of 4 cases and a stable visual acuity in 3 out of 4 cases. In red-free fundus photography, a reduction in drusen size and number could be observed in 4 out of 10 cases.
Conclusion:
The results of this investigation seem to be in accordance with data from previously published controlled clinical trials. Recommendations for the indication of rheopheresis for AMD should be further defined and evaluated within the framework base of a multicentric cooperative study.
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