INTRODUCTION: The age related macular degeneration (ARMD) is the most common cause of practical blindness in the population older than 60 years of age. Usually it starts as a dry form with soft drusen.The progression of the dry form is difficult to control-promising seems to be the influence of rheologic factors in the choroid and the retina and thus improvement of their blood flow. AIM: By means of haemorheopheresis to improve blood rheology and thus micocirculation in the choroid and retina. The authors describe the development of the dry form of the ARMD in the sensitive stage with soft drusen and the eventual presence of retinal pigment epithelium detachment (RPED) after haemorheopheresis. The treated patients were compared with a control group (natural course of the ARMD) with the same number of patients. METHODS: In a prospective, randomized study, comprising of 16 patients with the dry form of ARMD were treated with haemorheopheresis (cascade filtration) and 16 patients in the control group. Haemorheopheresis treatment comprised of 8 cycles in 10 weeks. Plasma obtained by separator was filtered by the Evaflux 4A (Japan) separator, where, the defined spectrum of high molecular proteins was captured. This lead to a decrease in blood and plasma viscosity and thus to improvement of rheologic conditions of the retina. RESULTS: Results show a positive influence on the absorption of soft drusen, reduction of the retinal pigment epithelium detachment, and the possibility to improve the visual acuity of the treated patients. CONCLUSION: Comparing to the worsening of clinical signs and visual functions in natural course of the ARMD development, the rheopheresis as well tolerated method may cause the retardation or stop of the unfavorable course of the disease.

Ocni klinika Lékarské fakulty UK a FN Hradec Králové