Changes of Hemorheological and Biochemical Parameters after Plasma Perfusion Using a Tryptophan-Polyvinyl Alcohol Adsorber Leading to Clinical Improvement in Patients Suffering from Maculopathy

Abstract

Background: Selective adsorption is an extracorporeal treatment able to reduce high-molecular-weight proteins and lipids. We evaluated its efficacy in lowering hemorheological parameters to achieve a better microcirculation of the retina. Patients and Methods: Ten patients suffering from maculopathies of various origin underwent a selective plasma adsorption procedure using the TR-350. Plasma and whole blood viscosity, erythrocyte aggregation and proteins and lipids were determined before and 24 h after therapy. Results: Selective adsorption therapy reduced the high-molecular-weight proteins and lipids. Plasma viscosity, standardized whole blood viscosity and erythrocyte aggregation were significantly lowered to 87, 88 and 65%, respectively, of their values prior to treatment. An improvement of visual acuity was achieved in 6/10 patients. Minor side effects were noted in 2/10 patients. Conclusions: Selective adsorption using the TR-350 adsorber is a safe technique, showing a high impact on blood rheology. The changes of hemorheological parameters led to clinical improvement in 6/10 patients suffering from retinal disorders.

The Effect of Membrane Differential Filtration on the Colloid Osmotic Pressure in Patients with Age‐Related Macular Degeneration: Significance to Visual Function?

“…The results of the present study show a clear association between high molecular weight protein and lipoprotein alterations by MDF and the biophysical properties of the plasma. The present study and several previous studies demonstrated that MDF is able to improve the macular function in patients with AMD (12,14–20). Thus, the question arises whether the effects of MDF on COP may contribute to the observed functional results.…”

“…These treatment strategies had in common the elimination of high molecular weight proteins and lipids by extracorporeal treatment procedures especially by membrane differential filtration resulting in an improvement of hemorheological parameters (12,13). Pilot studies and recent randomized trials demonstrated a functional improvement in patients with AMD (12,14–20). The aim of the present study was to investigate the effect of MDF on the plasma COP in patients suffering from non‐exudative AMD and to clarify its significance to visual function.…”

A Case Report of Double‐Filtration Plasmapheresis for the Treatment of Age‐related Macular Degeneration

“…The response rate of AMD patients to plasmapheresis has varied among reported series (9)(10)(11)(12). Direct comparisons among these reported series, however, are difficult because of the use of different plasmapheresis protocols, plasmapheresis filters, and outcome measures.…”

“…Through DFPP or PE, blood and plasma viscosity can be reduced with consequent improvements in hemorheology (7); therefore, rheopheresis is an application of DFPP for extracorporeal hemorheotherapy (8). Several papers have demonstrated the safety and efficacy of rheopheresis for the treatment of AMD patients since 1996, especially for those with the dry form and soft drusen (9)(10)(11)(12)(13). We report a patient with dry type AMD in his right eye who received a total of eight sessions of DFPP treatment within 10 weeks.We analyzed parameters representing the clinical efficacy and safety of DFPP for AMD at baseline and at 3, 6, 9, and 12 months after treatment of this patient.…”