97th DOG Annual Meeting 1999



C. L√ľke, R. A. Widder, F. Soudavar, P. Walter, R. Brunner, H. Borberg

Background: Altered blood rheology is discussed as an substantial contributor to the pathogenesis of diabetic retinopathy (DR). Membrane differential filtration (MDF) is an extracorporeal treatment process which is able to optimize rheological parameters by eliminating high molecular weight proteins and lipoproteins from the blood. The present study was designed to investigate the effects of repetitive treatment with MDF on macular function in DR.

Methods: 11 patients (11 eyes) with nonproliferative or inactive proliferative DR underwent three MDF cycles by means of cascade filtration (AR 2000, Asahi Medical Tokyo) during a mean period of 18 weeks (SD 4 weeks). Main parameters of visual outcome were visual acuity (ETDRS charts) and central visual field (30-2, Humphrey Instr.). Measurement of visual acuity, visual field, biochemical and rheological parameters was carried out 24 hours pre and post each cycle and at follow up. Mean follow up time was 9 weeks (SD 4 weeks) post treatment period.

Results: Compared to baseline examination visual acuity improved stepwise by a mean value of 1.4 lines (p = 0.02) post last treatment and remained stable at follow up (1.3 lines, p < 0.001). Mean defect of visual field was reduced by 2.8 dB (p = 0.13) post treatment period and by 2.5 dB (p = 0.016) at follow up, respectively.

Conclusions: Repetitive treatment with MDF is able to improve macular function in patients with DR. The present study suggests that repetitive MDF treatment could be a useful adjunct along with laser treatment to influence the clinical course of diabetic maculopathy.

Department of Ophthalmology, Cologne