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Application of HELP in nonarteritic anterior ischemic optic neuropathy: a prospective, randomized, controlled study.

AbstractBACKGROUND:
Heparin-induced extracorporeal LDL/fibrinogen precipitation (HELP) eliminates selectively fibrinogen, LDL, cholesterol, triglycerides and LP(a) from blood plasma using extracorporeal circulation. The reduction of fibrinogen and LDL by about 50% after only one procedure immediately improves the hemorheological situation.
METHOD:
In a prospective, randomized, controlled study over a period of 3 months, 40 patients with nonarteritic ischemic optic neuropathy (NAION) were randomly assigned to either HELP or hemodilution therapy to determine the efficacy of these two treatments on visual acuity and fields.
RESULTS:
After transformation of the Snellen acuity into logMAR units the statistical analysis did not show a significant difference between the two groups (P = 0.48). An increase of the visual acuity by two or more lines was obtained in 9 patients (47.4%) of the HELP group, 10 (52.6%) remained stable and none got worse. In the hemodilution group, visual acuity increased in patients (33.4%), 9 (42.8%) remained stable and 5 (23.8%) experienced a decrease. The calculated mean sensitivity of visual fields at baseline improved statistically significantly (P < 0.01) in the HELP group from 6.83 +/- 4.52 dB to 8.27 +/- 4.89 dB, but did not change significantly in the hemodilution group (6.25 +/- 4.12 dB to 6.12 +/- 3.92 dB).
CONCLUSION:
The HELP system seems to be safe and more effective than hemodilution in improving the hemorheological and the functional situation in NAION and could be a promising regimen in the treatment of NAION.
AuthorsA Haas, M Walzl, F Jesenik, B Walzl, A Berghold, J Berglöff, B Feigl, J Faulborn
JournalGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 235 Issue 1 Pg. 14-9 (Jan 1997) ISSN: 0721-832X [Print] Germany
PMID9034837 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)
Chemical References
  • Fibrinolytic Agents
  • Lipoproteins, LDL
  • Fibrinogen
  • Heparin
Topics
  • Aged
  • Arteritis (blood, physiopathology, therapy)
  • Blood Viscosity
  • Evoked Potentials, Visual (physiology)
  • Extracorporeal Circulation
  • Female
  • Fibrinogen (metabolism)
  • Fibrinolytic Agents (administration & dosage)
  • Fractional Precipitation
  • Hemodilution (methods)
  • Heparin (administration & dosage)
  • Humans
  • Lipoproteins, LDL (blood)
  • Male
  • Middle Aged
  • Optic Neuropathy, Ischemic (blood, physiopathology, therapy)
  • Prospective Studies
  • Visual Acuity
  • Visual Fields

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