Rheohaemapheresis of ophthalmological diseases and diseases of the microcirculation

Journal of Ophthalmology

et al. 2013

Purpose. Determining long-term effects of rheohaemapheresis on the dry form of age-related macular degeneration. Methods. This study evaluates 19 patients, average age of 67.6 years, treated with rheohaemapheresis and 18 patients, average age of 72.8 years, comprising the control group. Minimum follow up period was 3.5 years. Each treated patient received a series of 8 sessions of rheohaemapheresis of 1.5 plasma volumes within 10 weeks. We measured the drusenoid pigment epithelium detachment (DPED), best-corrected visual acuity (BCVA), electroretinography (ERG), and rheological parameters. Results. In the treatment group, the baseline BCVA was 0.74 (0.36–1.0) 95% CI and BCVA after 3.5 years was 0.79 (0.41–1.0) 95% CI (P = 0.726). In the control group, the baseline BCVA was 0.71 (0.15–1.0) 95% CI and BCVA after 3.5 years decreased to 0.7 (0.32–0.87) 95% CI (P = 0.031). Baseline DPED was 6.78 ± 3.79 mm2; after 3.5 years, it decreased to 4.13 ± 3.84 mm2 (P < 0.001). In the control group, the baseline DPED was 4.09 ± 3.48 mm2; after 3.5 years, it increased to 6.69 ± 4.2 mm2 (P = 0.001). We noted increasing levels of positive wave peaking at 50 milliseconds (P50) after treatment (P = 0.022) and a stable amplitude of photopic responses of treated patients. Conclusion. Over the long term, rheohaemapheresis reduced the DPED, improved the function of photoreceptors, and prevented the decline of BCVA.

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Rheohaemapheresis in the Treatment of Dry Form of Age-Related Macular Degeneration

Studnička

Journal of Ophthalmology

et al. 2013

“…RHF is used for the treatment of sudden hearing loss, age-related macular degeneration, peripheral arterial disease, and several other microcirculatory diseases [6, 7, 12, 13]. Data supporting the efficacy of this procedure have been published, but detailed pathophysiological explanations of the positive clinical effects are not clear or are missing.…”

Section: Discussionmentioning

confidence: 99%

“…In our previous study, we demonstrated that there is a reduction in the blood viscosity in AMD [9]. After RHF, a decrease in the macromolecule concentrations (mainly fibrinogen) occurred [14], whereas erythrocyte deformability improved [13]. Together, both led to improved blood supply in the microcirculation.…”

Section: Discussionmentioning

confidence: 99%

Dynamics of Blood Count after Rheohemapheresis in Age-Related Macular Degeneration: Possible Association with Clinical Changes

Košťál

BioMed Research International

et al. 2014

Background. Rheohemapheresis (RHF) is a method that can stop the activity of the dry form of age-related macular degeneration (AMD). The pathophysiologic mechanisms are not well understood, and the effects of the RHF procedures extend beyond the time of the individual procedures. Patients and Methods. We present the data for 46 patients with AMD treated with a series of 8 rheohemapheretic procedures. Blood count parameters were measured before the first and the last procedures. The clinical effect was judged by changes in the drusenoid pigment epithelium detachment (DPED) area before and after the rheopheretic sessions. Results. Rheopheresis caused a decrease in hemoglobin (P < 0.001), a decrease in leukocytes (P < 0.034), and an increase in platelets (P < 0.005). We found a negative correlation between the amount of platelets and their volume (P < 0.001, Pearson correlation coefficient: −0.509). We identified the platelet/MPV ratio as a good predictor of the clinical outcome. Patients with a platelet/MPV ratio greater than 21.5 (before the last rheopheresis) had a significantly better outcome (P = 0.003, sensitivity of 76.9% and specificity of 80%). Conclusion. Several basic blood count parameters after RHF can be concluded to significantly change, with some of those changes correlating with the clinical results (reduction of the DPED area).

“…The size of the filter pores enables catchments of a considerable amount of LDL-cholesterol, lipoprotein(a), fibrinogen, α 2 -macroglobulin and immunoglobulins, especially IgM. Other technical details are the same as during haemapheretic procedures (a more detailed description is in [2,3,6]). …”

Section: Our Modification Of Haemorheopheresismentioning

confidence: 99%

“…Physical laws related to blood rheology and/or organ perfusion are Ohm's law, Newton's law, Farhreus-Lindquist's law, Starling-Straubs and Kirchhoff's law. Hagen-Poiseuille's law is of major interest as it hints at the importance of viscosity under conditions where other variables can hardly be influenced [6]. Thus a set of variables arises along with a new situation in the tissue microcirculation at each moment.…”

Section: Introductionmentioning

confidence: 99%

The importance of rheological parameters in the therapy of microcirculatory disorders

Clinical Hemorheology and Microcirculation

et al. 2009

Rheological conditions basically influence tissue perfusion, oxygen and nutrient supply, tissue regeneration and in its consequence the course of pathological processes, especially in microcirculation and partially even in macrocirculation. Haemorheotherapy has shown to be successful in several indications (critical disorders in microcirculation) when other methods of therapy have failed. In this study we describe the changes of effectivity indicators in haemorheopheresis treatment and their clinical importance in cases of eye microcirculation, statoacoustic apparatus and disorders of the lower extremities. We treated with haemorheopheresis (separator Cobe.Spetra + Evaflux filter) 24 patients (16 patients with age related macular degeneration, 5 with critical peripheral arterial foot disease, and 3 with acute hearing loss). After the procedures α 2 -macroglobulin decreases by about 58%, fibrinogen by about 69%, IgM by about 61%, LDL-cholesterol by about 77%, apolipoprotein B by about 76% and lipoprotein(a) by about 63%. It corresponds with a decrease in blood and plasma viscosity and clinical improvement in the observed patients, i.e. visual improvement, acceleration of tissue defect healing and improvement in hearing. We noticed 7.1% clinically insignificant side-effects. The method of haemorheopheresis was safe. It led to improvement in patients' clinical condition in the above mentioned indications when other methods of treatment failed.