Artikel
Morphological changes under long-term treatment with therapeutic apheresis in patients with age-related macular degeneration (ARMD)
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Autoren
Veröffentlicht: | 22. September 2004 |
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Gliederung
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Objective
Therapeutic Apheresis is an extracorporeal treatment procedure able to eliminate high molecular weight proteins and lipids from the blood and therefore able to optimize rheological parameters. It was shown to be effective in influencing the natural course of the dry form of ARMD over a period of 4 years. This study investigates morphological changes in patients with ARMD undergoing therapeutic apheresis.
Methods
32 patients (32 eyes) underwent therapeutic apheresis (rheopheresis) over a period between 2 and 4 years. The mean treatment frequency was between 6 and 11 times a year. All patients suffered from the dry form of ARMD. The clinical endpoint was visual acuity of the patients (ETDRS-charts) and qualitative and quantitative morphological changes.
Results
After two years all patients showed a significant increase of visual acuity of 1.1 lines. The subgroup of patients with soft drusen showed an improvement of visual acuity of 1.5 lines and the improvement was significant after three years. The area of soft drusen did not change under treatment whereas the area of areolear atrophy enlarged.
Conclusions
This study showed that therapeutic apheresis is able to alter the natural course of ARMD. The subgroup of patients with soft drusen had the greatest advantage from therapy. The area of soft drusen did not change during therapy. Therefore the functional changes were not related to the morphological changes.