Haemorheopheresis could block the progression of the dry form of age-related macular degeneration with soft drusen to the neovascular form
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
PubMed
20102350
DOI
10.1111/j.1755-3768.2009.01710.x
PII: AOS1710
Knihovny.cz E-resources
- MeSH
- Biomarkers blood MeSH
- Electroretinography MeSH
- Photography MeSH
- Geographic Atrophy pathology therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Macular Degeneration pathology therapy MeSH
- Microcirculation physiology MeSH
- Follow-Up Studies MeSH
- Choroidal Neovascularization pathology therapy MeSH
- Retinal Detachment pathology therapy MeSH
- Tomography, Optical Coherence MeSH
- Plasmapheresis methods MeSH
- Disease Progression MeSH
- Rheology methods MeSH
- Retinal Drusen pathology therapy MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Visual Acuity MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Names of Substances
- Biomarkers MeSH
PURPOSE: To evaluate the influence of haemorheopheresis on anatomical and functional findings in patients with soft-drusen maculopathy. METHODS: We investigated 29 eyes (16 patients) and randomized 25 eyes (16 controls) with soft-drusen maculopathy [soft, confluent and reticular drusen, drusenoid retinal pigment epithelium detachment (RPED)]. Each patient received a series of eight haemorheophereses (cascade filtration of 1.5 plasma volume) within 10 weeks. The patients were followed up using Early Treatment Diabetic Retinopathy Study (ETDRS) charts, optical coherence tomography, fluorescein angiography, electroretinography and measurements of pulsed ocular blood flow. RESULTS: After the procedures, there was a substantial reduction in rheologically active substances [lipoproteins, α2-macroglobulin, immunoglobulin M (IgM), fibrinogen], plasma and blood viscosity. At the 1.5-year follow-up, we noticed soft drusen absorption; reattachment of drusenoid RPED and stabilization or improvement of visual acuity occurred in 72% of patients in comparison to only 39% of patients in the control group. Full-field electroretinograms showed significantly higher scotopic activity of treated patients in comparison with the control group, and mainly insignificant differences in photopic activity between both groups. Despite the significant increase of activity in the paramacular retina in treated patients, the differences in amplitudes of multifocal electroretinography (mfERG) average responses were insignificant between groups. CONCLUSION: Haemorheopheresis seems to be capable of changing the activity of promoters of the natural course of soft-drusen maculopathy, its development and progression. Visual acuity and electrical activity of the retina can be stabilized or even improved. The therapy has been shown to be effective and safe.
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