Rheopheresis is an extracorporal selective double-filtration procedure. In the first part of the treatment the blood is passes through the plasma filter, which separates blood cells from the plasma. Then the plasma flow to a second filter called MONET (Membranefiltration Optimised Novel Extracorporal Treatment). The MONET filter retains high molecular weight proteins such LDL, Lp(a), fibrinogen, α2 macroglobulin, vWF and IgM. Hereby the whole blood and plasma viscosity decrease, improves microcirculation, and has a positive effect on lipid profile as well.
Accorging to ASFA recommendation rheopheresis is a first line treatment in age-related dry macular degeneration and in sudden sensorineural hearing loss. There are other clinical situations in which rheopheresis has been used effectivly. But only few data are available and large clinical trials have not been done in these diseases. In this paper we describe a case history and laboratory findings of a patient who suffers from age related dry macular degeneration and was successfully treated by rheopheresis.
Age-Related Eye Disease Study 2 Research, Group, Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: The age-related eye disease study 2 (AREDS2) randomized clinical trial, JAMA309 (2013), 2005–2015.
2.
Age-Related Eye Disease Study Research Group, A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. 8, Arch Ophthalmol119 (2001), 1417–1436.
3.
BrunnerR., WidderR.A., WalterP., BorbergH. and OetteK., Change in hemorrheological and biochemical parameters following membrane differential filtration, J Artif Organs18(12) (1995), 794–798.
4.
BrunnerR., WidderR.A., WalterP., LükeC., GodehardtE., Bartz-SchmidtK.U., HeimannK. and BorbergH., Influence of membrane differential filtration on the natural course of age-related macular degeneration: A randomized trial, Retina20(5) (2000), 483–491.
5.
BuschiniE., FeaA.M., LaviaC.A., NassisiM., PignataG., ZolaM. and GrignoloF.M., Recent developments in the management of dry age-related macular degeneration, Clin Ophthalmol9 (2015), 563–574.
6.
CaralloC., LopreteA., MazzaG., BellottiG., de SienaM., SerraoP.VuotoE.S., de FranceschiM.S., IraceC. and GnassoA., Biphasic hemodynamic effects of LDL-apheresis in common carotid artery, Clin HemorheolMicrocirc60(3) (2015), 297–307.
7.
Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the Writing Committee of the American Society for Apheresis: The sixth special issue, J Clin Apher28(3) (2013), 145–284. doi: 10.1002/jca.21276
8.
HardemanM.R., GoedhartP.T., ShinS., Methods in hemorheology.
In: Handbook of hemorheology and hemodynamics,
BaskurtOK, HardemanMR, RamlingMW, MeiselmanHJ, eds. IOS Press, Amsterdam, 2007, pp. 242–266.
9.
KlingelR., ErdtrachtB., GaussV., PiazoloA., Mausfeld-LafdhiyaP. and DiehmC., Rheopheresis in patients with critical limb ischemia–results of an open label prospective pilot trial, Ther Apher Dial9 (2005), 473–481.
10.
KlingelR., FassbenderC., HeibgesA., KochF., NasemannJ., EngelmannK., CarlT., MeinkeM. and ErdtrachtB., RheoNet registry analysis of rheopheresis for microcirculatory disorders with a focus on age-related macular degeneration, Ther Apher Dial14 (2010), 276–286.
11.
KossM.J., KurzP., TsobanelisT., LehmacherW., FassbenderC., KlingelR. and KochF.H., Prospective, randomized, controlled clinical study evaluating the efficacy of Rheopheresis for dry age-related macular degeneration. Dry AMD treatment with Rheopheresis Trial-ART, Graefes Arch Clin Exp Ophthalmol247 (2009), 1297–1306.
12.
MatraiA., WhittingtonR.B. and ErnstE., A simple method of estimating whole blood viscosity at standardized hematocrit, Clin Hemorheol7 (1987), 261–265.
13.
MellwigK.P., BallerD., GleichmannU., MollD., BetkerS., WeiseR. and NotohamiprodjoG., Improvement of coronary vasodilatation capacity through single LDL apheresis, Atherosclerosis139(1) (1998), 173–178.
14.
MichelsS., RosenfeldP.J., PuliafitoC.A., MarcusE.N. and VenkatramanA.S., Systemic bevacizumab (Avastin) ther- apy for neovascular age-related macular degeneration twelve-week results of an uncontrolled open-label clini- cal study, Ophthalmology112 (2005), 1035–1047.
15.
NémethJ., FrigyikA., VastagO., GöczeP., PetőT. and ElekI., Vaksági okok Magyarországon 1996 és 2000 között, Szemészet142 (2005), 127–133.
16.
PulidoJ.S., WintersJ.L. and BoyerD., Preliminary analysis of the final multicenter investigation of rheopheresis for age related macular degeneration (AMD) trial (MIRA-1) results, Trans Am Ophthalmol Soc104 (2006), 221–231.
17.
PulidoJ.S., Multicenter Investigation of Rheopheresis for AMD (MIRA-1) Study Group. Multicenter prospective, randomized, double-masked, placebo-controlled study of Rheopheresis to treat nonexudative age-related macular degeneration: Interim analysis, Trans Am Ophthalmol Soc100 (2002), 85–106; discussion 106–7.
18.
RencováE., BláhaM., StudničkaJ., BláhaV., LánskáM., RencO., StepanovA., KratochvílováV. and LangrováH., Preservation of the photoreceptor inner/iuter segment junction in dry age-related macular degeneration treated by rheohemapheresis, J Ophthalmol2015 (2015), 359747.
19.
RingelJ., MS80 lipoprotein filtration by monet: First clinical application in LDL removal, Atherosclerosis Supplements11(2) (2010), 126.
20.
Schuff-WernerP., Extracorporeal hemorheotherapy with selective plasma protein elimination, Jpn, J Apheresis16 (1997), 25–30.
21.
SchwartzJ., WintersJ.L., PadmanabhanA., BalogunR.A., DelaneyM., LinenbergerM.L., SzczepiorkowskiZ.M., WilliamsM.E., WuY. and ShazB.H., Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the Writing Committee of the American Society for Apheresis: The sixth special issue, J Clin Apher28 (2013), 145–284.
22.
WidderR.A., BrunnerR. and BorbergH., Changes of haemorheological parameters when using plasma exchange, selective adsorption and membrane differential separation, Transfus Sci17(4) (1996), 505–510.
23.
WolfS., SchulteK., ArendO., GlöcknerW.M., HandtS., JungF. and ReimM., Correlation between retinal microcirculation, plasma viscosity and visual function in patients with macroglobulinemia, Clin Hemorheol12 (1992), 725–731.
