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Rheopheresis may benefit patients with soft drusen
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RIO GRANDE, Puerto Rico — An outpatient procedure that takes about 3 hours has shown demonstrable results in lowering plasma levels and treating age-related macular degeneration, said Frank H.J. Koch, Prof. Dr.med., here at the Masters of the American Society of Retina Specialists meeting.
Rheopheresis is “the elimination of rheologically relevant high molecular plasma proteins” from the eye, Dr. Koch said. For nonexudative AMD, the target for a single rheopheresis treatment is “100% of the individual plasma volume, with a minimum of 70%,” he said. Repeated, pulsed reduction of the blood and plasma viscosity leads to rapid alteration of the blood flow, he said, which induces a “continuing improvement of the microcirculation.”
Ophthalmologists need to work with an internist for the most successful experience, Dr. Koch said. He recommended rheopheresis for patients with dry AMD, soft drusen, mild pigment distribution or initial atrophy, with a visual acuity between 0.1 and 0.6.
In Frankfurt, 128 eyes of 91 patients underwent one treatment of rheopheresis. At the 23-week follow-up point, none of the patients had lost any lines of vision, 7% gained at least three lines, 39% had a one-line gain, 12% had a two-line gain, and 7% lost one to two lines. The outcomes match results from other centers as well, Dr. Koch said.
“This is not a treatment option for patients with exudation, bleeding, progressive atrophy or fibrosis,” he said. “Late AMD in the fellow eye is not a contraindication, however.”
In Europe, each treatment costs around 10,000 euros (US$11,963).
“Success can be dramatic and correlated very well with a loss of drusen, or it can be dramatic and not correlate that much with a loss of drusen,” said Dr. Koch.