It is known that the pathophysiological processes leading to age-related macular degeneration (AMD) are not yet fully understood. Little attention is paid to reduced microcirculation that often is observed in old age. However, a therapeutic approach developed early on has been used successfully for many years to treat AMD (1).
Plasmapheresis improves the rheological properties of blood, in particular by eliminating large protein particles. Plasmapheresis can thereby improve microcirculation and thus possibly promote the removal of accumulated metabolic by-products. Plasmapheresis can be used to treat AMD, sudden hearing loss, microangiopathies, and other disorders of microcirculation. However, pathophysiological explanations for the positive effects achieved here are also lacking (2).
The American Society for Apheresis recommends grade 2B in its current guidelines for the therapy of dry AMD using plasmapheresis. It can then be used as second-line therapy alone or in combination with other therapeutic options (3).
Rheohemapheresis is a safe therapy option that is not overly intrusive for the patient. For the correct indication, it can complement the therapy options described by Stahl et al. (4) and can at least slow down the course of dry AMD. In addition, positive rheological effects can be demonstrated not only locally but also systemically.
The costs for an outpatient rheohemapheresis therapy are usually not covered by statutory health insurance.
Footnotes
Conflict of interest statement
Jürgen Otto has received reimbursement of meeting participation fees and travel expenses from Haemonetics Corporation and lecture fees from Miltenyi Biotec.
References
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