Fell A J, Engelmann K, Richard G, Fassbender C, Wahls W, Klingel R
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Germany.
Ophthalmologe. 2002 Oct;99(10):780-4. doi: 10.1007/s00347-002-0614-0.
Choroidal microcirculation is impaired in age-related macular degeneration (AMD), and leads to deposition of lipids and proteins in Bruch's membrane. Rheophoresis can improve choroidal microcirculation by eliminating high molecular weight, rheologically relevant plasma proteins. The objective of this post-certification study was to analyse the effect of rheophoresis in 10 AMD patients.
A total of 6 patients with early AMD and 4 with late AMD in one eye (initial visual acuity equivalent 0.2-0.8) received rheophoresis treatment 10 times over an 18-week period. Visual acuity and color vision were determined initially and after 3, 5 and 12 months and fluorescein angiography was performed.
Patients with early AMD showed improvement of visual acuity (2 lines on ETDRS charts) in 2 out of 6 cases and a stable visual acuity in 4 out of 6 cases 1 year after rheophoresis, whereas patients with late AMD showed improvement of visual acuity (2 lines on ETDRS charts) in 1 out of 4 cases and a stable visual acuity in 3 out of 4 cases. In red-free fundus photography, a reduction in drusen size and number could be observed in 4 out of 10 cases.
The results of this investigation seem to be in accordance with data from previously published controlled clinical trials. Recommendations for the indication of rheopheresis for AMD should be further defined and evaluated within the framework base of a multicentric cooperative study.
年龄相关性黄斑变性（AMD）患者脉络膜微循环受损，导致脂质和蛋白质在 Bruch 膜沉积。流变电泳可通过清除高分子量、具有流变学相关性的血浆蛋白来改善脉络膜微循环。这项认证后研究的目的是分析流变电泳对 10 例 AMD 患者的影响。
共有 6 例早期 AMD 患者和 4 例晚期 AMD 患者（单眼初始视力相当于 0.2 - 0.8）在 18 周内接受了 10 次流变电泳治疗。在治疗开始时以及治疗后 3 个月、5 个月和 12 个月测定视力和色觉，并进行荧光素血管造影。
流变电泳治疗 1 年后，6 例早期 AMD 患者中有 2 例视力改善（ETDRS 视力表上提高 2 行），6 例中有 4 例视力稳定；4 例晚期 AMD 患者中有 1 例视力改善（ETDRS 视力表上提高 2 行），4 例中有 3 例视力稳定。在无赤眼底照相中，10 例中有 4 例可观察到玻璃膜疣大小和数量减少。
本研究结果似乎与先前发表的对照临床试验数据一致。应在多中心合作研究的框架基础内进一步明确和评估 AMD 流变电泳治疗适应证的建议。
