DELP Treatment on Vision and Retinal Microcirculation in Patients With Acute Ischemic Stroke: Report of Five Cases...

The delipid extracorporeal lipoprotein filter from plasma (DELP) treatment can effectively reduce blood lipid, increase blood flow, and improve neurological deficits in patients with acute ischemic stroke (AIS). However, its effect on vision and retinal microcirculation in stroke patients has never been reported.

Between November 2023 and June 2024, five patients underwent DELP treatment as a routine adjuvant therapy for AIS. Detailed ophthalmological examinations, including best corrected visual acuity (BCVA) and optical coherence tomography angiography (OCTA), were performed on them one day prior to and 1-3 days following the DELP treatment.

Among the ten eyes examined, six had diabetic retinopathy (DR), two had dry age-related macular degeneration (dAMD), one had idiopathic epiretinal membrane (iERM), and one was normal. Surprisingly, after DELP treatment, the BCVA improved by 0.2LogMAR in six eyes, 0.1LogMAR in three eyes, and remained unchanged in one eye. The vessel density (VD) in the fovea increased in six eyes, remained unchanged in three eyes, and decreased in one eye. The non-perfusion area (NPA) in the superficial capillary plexus (SCP) decreased in six eyes, remained unchanged in two eyes, and increased in two eyes. The NPA in the deep capillary plexus (DCP) decreased in eight eyes and remained unchanged in two eyes. A small amount of bleeding occurred in Patient 3's right eye, and no other adverse events were observed post-treatment.

In this case series, the DELP treatment showed a potentially significant therapeutic effect on the BCVA and retinal microcirculation in AIS patients with good safety and provided a rationale for further investigation. At the same time, this treatment may provide an effective option for the treatment of eye diseases such as DR, iERM, and AMD.