[Rheophoresis. A systematic approach to therapy of age-related macular degeneration (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.


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.


CONCLUSIONS
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.
Fell
A J
AJ
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Germany. fell@uke.uni-hamburg.de
Engelmann
K
K
Richard
G
G
Fassbender
C
C
Wahls
W
W
Klingel
R
R
D000368:Aged; D000369:Aged, 80 and over; D001781:Blood Component Removal; D001798:Blood Proteins / Q000378:metabolism*; D001809:Blood Viscosity / Q000502:physiology*; D002829:Choroid / Q000098:blood supply*; D003118:Color Perception / Q000502:physiology; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008833:Microcirculation / Q000503:physiopathology; D008970:Molecular Weight; D015593:Retinal Drusen / Q000503:physiopathology / Q000628:therapy; D014792:Visual Acuity / Q000502:physiology
D001798:Blood Proteins