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RHEOPHERESIS IN THE TREATMENT OF AGE-RELATED MACULAR DEGENERATION.

H Langrová, E Rencová, M Bláha

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    Summary

    Rheopheresis treatment for dry age-related macular degeneration (AMD) stabilized vision and improved retinal structure. Booster therapy further enhanced these positive anatomical and functional outcomes, demonstrating a safe and effective treatment approach.

    Keywords:
    DPEDERGdry form of AMDellipsoid layer of photoreceptorsrheopheresis

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    Area of Science:

    • Ophthalmology
    • Retinal Diseases
    • Medical Technology

    Background:

    • Age-related macular degeneration (AMD) is a leading cause of vision loss.
    • Dry AMD, characterized by drusen and pigmentary changes, can progress to advanced stages.
    • Current treatments for dry AMD are limited, necessitating novel therapeutic strategies.

    Purpose of the Study:

    • To evaluate the long-term efficacy and safety of rheopheresis in patients with dry age-related macular degeneration.
    • To assess the impact of rheopheresis on visual acuity, retinal morphology, and ocular function.
    • To investigate the potential benefits of adjunctive rheopheresis therapy.

    Main Methods:

    • A prospective study involving 65 patients receiving rheopheresis and 55 controls, with a minimum 60-month follow-up.
    • Rheopheresis treatment involved 8 procedures, with an optional 2-procedure booster therapy 1.5-2 years later.
    • Evaluated parameters included best-corrected visual acuity, anatomical changes, retinal electrical activity, and various blood markers.

    Main Results:

    • Rheopheresis stabilized visual acuity in treated patients, unlike the control group where it declined significantly over time.
    • Significant improvements in morphological findings and a reduced rate of disease progression to advanced AMD were observed in the rheopheresis group.
    • Treatment led to regression of drusenoid pigment epithelial detachment (DPED), preservation of the ellipsoid layer, and stabilized retinal electrical activity.
    • Rheopheresis improved rheological parameters, microcirculation, retinal metabolism, and modulated complement pathways and PCSK9/LDL-cholesterol levels.
    • Booster therapy was safe and effective in prolonging stabilization or improving outcomes.

    Conclusions:

    • Rheopheresis treatment demonstrates significant positive effects on anatomical, functional, and humoral parameters in dry AMD.
    • The findings support individualized rheopheresis therapy based on patient risk factors.
    • Rheopheresis is an effective and safe treatment option for dry AMD with a low incidence of adverse effects.