97th DOG Annual Meeting 1999
INFLUENCE OF MEMBRANE DIFFERENTIAL FILTRATION ON VISUAL ACUITY IN PATIENTS SUFFERING FROM AGE-RELATED MACULAR DEGENERATION - A RANDOMIZED TRIAL
R. A. Widder, R. Brunner, P. Walter, C. Lüke, E. Godehardt, H. Borberg
Background: Membrane differential filtration is able to optimize rheological parameters by eliminating high molecular weight proteins and lipoproteins from the blood. Following the hypothesis that these changes result in an improvement of the microcirculation we tested their efficacy in improving the visual function in patients suffering from AMD.
Patients and methods: 40 patients (40 eyes) were randomized into two groups. The treatment group was treated five times over a period of 21 weeks. In both groups 9/20 of the eyes showed (subfoveolar) subretinal neovascularisations. The main parameter of the study was the visual acuity. ERG, EOG and macular visual evoked potentials were also recorded. Plasma viscosity, whole blood viscosity and erythrocyte aggregation were measured.
Results: The 20 patients, treated repeatedly over a period of 21 weeks, showed a mean improvement of 0.63 lines (SD 1.8) of visual acuity on ETDRS charts while the control group showed a deterioration of 0.94 lines (SD 1.7) compared to their visual acuity at baseline examination. The amplitude of the ERG photopic a-wave and the flicker ERG was significantly increased. The rheological parameters were lowered in all treated patients.
Discussion: We conclude that a repetitive treatment with membrane differential filtration is able to improve the visual acuity of patients with AMD and the natural course of this disease. Several questions arise from the results of this study. Further research will show if it is possible to optimize the selection of patients for subgroups with predictive responses through morphological and functional tests and how to create an optimized and individual treatment strategy determined by the quality, intensity and frequency of treatment sessions.
Zentrum für Augenheilkunde und Hämapherese des Zentrums für Innere Medizin der Universität zu Köln, 50924 Köln, Klinik für Thorax- und Kardiovaskularchirurgie
Heinrich Heine Universität Düsseldorf, 44225 Düsseldorf