35. Rheopheresis – update 2007
Michael Janusz Koss, F. H. Koch (Frankfurt/Main)
In the majority of dry age-related macular degeneration (AMD) patients the therapeutic situation is
very unsatisfactory. Elimination of a defined spectrum of high molecular weight proteins by pulses of
lowering blood and plasma viscosity performed as series of Rheopheresis treatments lead to rapid
reduction of relevant risk factors for dry AMD such as fibrinogen, LDL-cholesterol, a2-macroglobulin,
fibronectin, and von-Willebrand factor thus inducing sustained improvement of microcirculation,
and recovery of retinal function. Results of the controlled randomised trials MAC-I, Utah, MIRA-1,
experience in clinical practice including long-term treatment with a significant therapeutic effect after
12 months. The RheoNet register data justify to offer Rheopheresis to high-risk patients with dry AMD
(large confluent soft drusen). As Rheopheresis is a safe and effective modality of therapeutic apheresis
to treat microcirculatory disorders, and represents a novel therapeutic approach for patients with
dry AMD and soft drusen an international multi-center randomized sham controlled double masked trial was initiated, which included
patients (age 50 to 85 years; bodyweight 50 to 100 kg; BCVA 20/40 to 20/100) with dry AMD and a clinical presentation of soft,
semi-soft, or confluent drusen.