The aim of the study was to test the clinical efficacy of haemorheological treatment with extracorporeal techniques in ocular diseases. We treated patients suffering from
maculopathies of different origin: age-related (AMD, n = 17),
uveitis-associated (n = 14) and
myopia-associated
maculopathy (n = 5). We also treated patients with
uveal effusion syndrome (n = 3) and
central retinal vein occlusion (n = 4) resistant to haemodilution or
steroid therapy. The treatment consisted of
plasma exchange, selective adsorption with a
tryptophan-polyvinylalcohol adsorber and membrane differential filtration.
Maculopathy patients underwent two treatments while the other patients received between 1 and 7 treatments. Pulsatile ocular blood flow was measured in 10 patients before and after
therapy. The main parameter for evaluating clinical outcome was the change in visual acuity. Severe side-effects did not occur. The rheological parameters including plasma viscosity, whole blood viscosity and erythrocyte aggregation were statistically significantly lowered. Of 36 patients suffering from
maculopathy, 25 showed an improvement of at least 1 line of visual acuity after
therapy, 7/17 patients in AMD, 6/14 in
uveitis and 0/5 in
myopia improved 3 lines or more. All patients suffering from
retinal vein occlusion improved at least 1 line and two showed an improvement of 3 lines or more. In
uveal effusion syndrome, an improvement of 3 lines or more was reached in all patients.
Plasma exchange, selective adsorption and membrane differential filtration are effective rheological treatment approaches to improving visual acuity in patients suffering from
maculopathy except
myopia-associated
maculopathy. Efficacy in patients suffering from
central retinal vein occlusion and
uveal effusion syndrome was proven, even when the patients were resistant to previous haemodilution or
steroid therapy. We conclude that a rheological approach should be considered before invasive methods such as
laser coagulation,
radiation therapy or surgery are applied.