{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:56Z","timestamp":1789609136064,"version":"build-2803163510"},"reference-count":50,"publisher":"Czech Society of Ophthalmology of the CzMA","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CSO"],"published-print":{"date-parts":[[2023,2,20]]},"abstract":"<jats:p>Purpose: Evaluation of the long-term effect of rheopheresis treatment of dry form of age-related macular degeneration (AMD).\nMaterials and Methods: The treatment group consisted of 65 patients and 55 patients in the control group, with a\u00a0minimum follow-up period of 60 months. The basic treatment consisted of 8 rheopheresis procedures, and the additional treatment (booster therapy) of 2 rheopheresis procedures 1.5\u20132 years after the basic treatment. We evaluated changes in best corrected visual acuity, anatomical effect, electrical activity of the retina, haematological, biochemical and immunological parameters.\nResults: Rheopheresis treatment contributed significantly: 1) to stabilisation of best corrected visual acuity of the treated patients, which initially showed an insignificant increased during the 2-years follow-up period, and then slightly decreased. By contrast, visual acuity decreased in the control group, to an insignificant degree up to 4 years, then statistically significantly. 2) to an improvement of the morphological findings in 62.4% of treated patients compared to 7.5% in the control group, while disease progression to stage 3 (neovascular form of the disease or geographic atrophy) with a\u00a0significant decrease of visual acuity occurred in only 7.1% of treated patients, versus 37.0% in the control group. 3) to regression, even to the attachment of drusenoid pigment epithelial detachment (DPED). To a\u00a0reduction of the area of DPED in 80.4% of treated patients, in contrast with an increase in the area of DPED in 47.1% of patients in the control group, and the development of new DPED in only 2 eyes of treated patients compared with 16 eyes of patients in the control group. 4) to a\u00a0preservation of the integrity of the ellipsoid layer in the fovea in 68.2% of the treated patients, while by contrast we found a\u00a0damaged ellipsoid layer in the fovea in 66.6% of the control patients. 5) to a\u00a0stabilisation of the activity of ganglion cells, the pineal system and the activity of the central area of the retina, with eccentricity between 1.8\u00b0 and 30\u00b0 in the treated patients, compared to alteration in the control group manifested mainly after 3.5 years of the follow-up period. 6) to a\u00a0statistically significant improvement in rheological parameters, thereby increasing flow in microcirculation and positively influencing the metabolism in the retina. Also to a\u00a0positive effect on the classical, alternative and lectin pathway of complement activation, a\u00a0reduction in the level of proprotein convertase subtilisin kexin 9 (PCSK9), and thus also the level of LDL-cholesterol, and 7) Additional treatment with 2 RHF procedures (so-called \"booster therapy\") seems to be a\u00a0safe and suitable method of prolonging the stabilisation phase, or even improving visual acuity, anatomical and functional findings.\nConclusion: We demonstrated positive changes in anatomical, functional and humoral parameters upon rheopheresis treatment of AMD. Their correlation provides a\u00a0real possibility to identify patients at risk and to manage an individualised regime of rheopheresis therapy. This method of treatment is effective and safe, with a\u00a0low percentage of non-serious adverse effects.<\/jats:p>","DOI":"10.31348\/2023\/2","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T13:42:32Z","timestamp":1688737352000},"page":"8-24","source":"Crossref","is-referenced-by-count":2,"title":["Rheopheresis in the Treatment of Age-Related Macular Degeneration"],"prefix":"10.31348","volume":"79","author":[{"given":"Han","family":"Langrov\u00e1","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladim\u00edr","family":"Bl\u00e1ha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Dvo\u0159\u00e1kov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0160\u00e1rka","family":"Jedl\u00ed\u010dkov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marya","family":"Burova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Breznayov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandr","family":"St\u011bpanov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Studni\u010dka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan","family":"Bl\u00e1ha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Rencov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"L\u00e1nsk\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16213","published-online":{"date-parts":[[2023,2,20]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Seddon JM, Chen CA. The epidemiology of age-related macular degeneration. Int Ophthalmol Clin Fall. 2004;44(4):17-39.","DOI":"10.1097\/00004397-200404440-00004"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Brown DM, Michels M, Kaiser PK, et al. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: Two-year results of the ANCHOR study. Ophthalmology. 2009;116(1):57-65.e55.","DOI":"10.1016\/j.ophtha.2008.10.018"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Donaldson MJ, Pulido JS. Treatment of nonexudative (dry) age-related macular degeneration. Curr Opin Ophthalmol. 2006;17(3):267-274.","DOI":"10.1097\/01.icu.0000193101.13551.e5"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Rencov\u00e1 E, Bl\u00e1ha M, Bla\u017eek M, et al. Mo\u017enost ovlivn\u011bn\u00ed such\u00e9 formy v\u011bkem podm\u00edn\u011bn\u00e9 makul\u00e1rn\u00ed degenerace hemorheofer\u00e9zou [Influence of haemorheopheresis in the dry form of the age related macular degeneration]. Cesk Slov Oftalmol. 2009;65(2):43-48. Czech.","DOI":"10.1111\/j.1755-3768.2009.01710.x"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Klein R. Overview of progress in the epidemiology of age-related macular degeneration. Ophthalmic Epidemiol. 2007;14(4):184-187.","DOI":"10.1080\/09286580701344381"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Rencov\u00e1 E, Bl\u00e1ha M, Langrov\u00e1 H, et al. Haemorheopheresis could block the progression of the dry form of age-related macular degeneration with soft drusen to the neovascular form. Acta Ophthalmol. 2011;89(5):463-471.","DOI":"10.1111\/j.1755-3768.2009.01710.x"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Rencov\u00e1 E, Bl\u00e1ha M, Langrov\u00e1 H, et al. Preservation of the Photoreceptor Inner\/Outer Segment Junction in Dry Age-Related Macular Degeneration Treated by Rheohemapheresis. J Ophthalmol. 2015;2015:359747.","DOI":"10.1155\/2015\/359747"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Troutbeck RS, Al-qureshi RS, GUYME RH. Therapeutic targeting of the complement system in age-related macular degeneration: a review. Clin Experiment Ophthalmol. 2012;40(1)18-26.","DOI":"10.1111\/j.1442-9071.2011.02581.x"},{"key":"ref8","unstructured":"Wang X, Zhang Y, Zhang MN. Complement factor B polymorphism (rs641153) and susceptibility to age-related macular degeneration: evidence from published studies. Int J Ophthalmol. 2013;6(6):861-867."},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Bl\u00e1ha M, Andr\u00fds C, Langrov\u00e1 H, et al. Changes of the complement system and rheological indicators after therapy with rheohemapheresis. Atheroscler Suppl. 2015;18:140-145.","DOI":"10.1016\/j.atherosclerosissup.2015.02.009"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Friedman E. The pathogenesis of age-related macular degeneration. Am J Ophthalmol. 2008;146(3):348-349.","DOI":"10.1016\/j.ajo.2008.05.017"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"De Amorim Garcia Filho CA, Yehoshua Z, Gregori G, et al. Change in drusen volume as a novel clinical trial endpoint for the study of complement inhibition in age-related macular degeneration. Ophthalmic Surg Lasers Imaging Retina. 2014;45(1):18-31.","DOI":"10.3928\/23258160-20131217-01"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Tamai KA, Matsubara K, Tomida A, et al. Lipid hydroperoxide stimulates leukocyte-endothelium interaction in the retinal microcirculation. Exp Eye Res. 2002;75(1):69-75.","DOI":"10.1006\/exer.2002.1178"},{"key":"ref13","unstructured":"Tserentsoodol Na, Sztein J, Campos N, et al. Uptake of cholesterol by the retina occurs primarily via a low density lipoprotein receptor-mediated process. Mol Vis. 2006;12:1306-1318."},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Fliesler SJ, Florman R, RapP LM, et al. In vivo biosynthesis of cholesterol in the rat retina. FEBS Lett. 1993;335(2):234-238.","DOI":"10.1016\/0014-5793(93)80736-e"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"Benjannet S, Rhainds D, Essalmani R, et al. NARC-1\/PCSK9 and its natural mutants: zymogen cleavage and effects on the low density lipoprotein (LDL) receptor and LDL cholesterol. J Biol Chem. 2004;279(47):48865-48875.","DOI":"10.1074\/jbc.m409699200"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Age-related eye disease study research group: A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta karotene and zinc for age-related macular degeneration and vision loss. AREDS Report 8. Arch Ophthalmol. 2001;119:1417-1436.","DOI":"10.1001\/archopht.119.10.1417"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Klingel R, Fassbender C, Heibges A, et al. RheoNet registry analysis of rheopheresis for microcirculatory disorders with a focus on age-related macular degeneration. Ther Apher Dial. 2010;14(3):276-286.","DOI":"10.1111\/j.1744-9987.2010.00807.x"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Rencov\u00e1 E, Bl\u00e1ha M, Langrov\u00e1 H, et al. Reduction in the drusenoid retinal pigment epithelium detachment area in the dry form of age-related macular degeneration 2.5 years after rheohemapheresis. Acta Ophthalmol. 2013;91(5):e406-408.","DOI":"10.1111\/j.1755-3768.2012.02503.x"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Schwartz J, Winters JL, Padmanabhan A, et al. 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 Apher. 2013;28(3):145-284.","DOI":"10.1002\/jca.21276"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Studnicka J, Rencova E, Blaha M, et al. Long-term outcomes of rheohaemapheresis in the treatment of dry form of age-related macular degeneration. J Ophthalmol. 2013; 135798.","DOI":"10.1016\/j.atherosclerosissup.2012.10.023"},{"key":"ref21","unstructured":"Rozs\u00edval P, Bar\u00e1kov\u00e1 D, Bl\u00e1ha M, et al. Trendy soudob\u00e9 oftalmologie 7. Edition ed. Praha: Gal\u00e9n. 2011. 225 p. ISBN 978-80-7262-691-5."},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Schwartz J, Padmanabhan A, Aqui N, et al. Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach from the Writing Committee of the American Society for Apheresis: The Seventh Special Issue. J Clin Apher. 2016;31(3):149-162.","DOI":"10.1002\/jca.21470"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Klingel R, Fassbender C, Fassbender, et al. Rheopheresis: rheologic, functional, and structural aspects. Ther Apher. 2000;4(5):348-357.","DOI":"10.1046\/j.1526-0968.2000.004005348.x"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Klingel R, Fassbender C, Fassbender T, Gohlen B. Clinical studies to implement Rheopheresis for age-related macular degeneration guided by evidence-based-medicine. Transfus Apher Sci. 2003;29(1):71-84.","DOI":"10.1016\/s1473-0502(03)00101-0"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Berrouschot J, Barthel H, Scheel C, et al. Extracorporeal membrane differential filtration--a new and safe method to optimize hemorheology in acute ischemic stroke. Acta Neurol Scand. 1998;97(2):126-130.","DOI":"10.1111\/j.1600-0404.1998.tb00621.x"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Brunner R Widder RA, Walter P, et al. Change in hemorrheological and biochemical parameters following membrane differential filtration. Int J Artif Organs. 1995;18(12):794-798.","DOI":"10.1177\/039139889501801208"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Borberg H, Tauchert M. Rheohaemapheresis of ophthalmological diseases and diseases of the microcirculation. Transfus Apher Sci. 2006;34(1):41-49.","DOI":"10.1016\/j.transci.2005.09.001"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Bl\u00e1ha, M. Extracorporeal LDL-cholesterol elimination in the treatment of severe familial hypercholesterolemia. Acta Medica (Hradec Kr\u00e1lov\u00e9). 2003;46(1):3-7.","DOI":"10.14712\/18059694.2019.1"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Bl\u00e1ha, M, Cermanov\u00e1 M, Bl\u00e1ha V, et al. Safety and tolerability of long lasting LDL-apheresis in familial hyperlipoproteinemia. Ther Apher Dial. 2007;11(1):9-15.","DOI":"10.1111\/j.1744-9987.2007.00450.x"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Bl\u00e1ha M, Rencov\u00e1 E, Bl\u00e1ha V, et al. Rheopheresis in vascular diseases. Int J Artif Organs. 2008;31(5):456-457.","DOI":"10.1177\/039139880803100512"},{"key":"ref31","unstructured":"L\u00e1nsk\u00e1 M, Bl\u00e1ha M, \u017d\u00e1k P. Extrakorpor\u00e1ln\u00ed eliminace cholesterolu u famili\u00e1rn\u00ed hypercholesterolemie \u2013 srovn\u00e1n\u00ed dvou metod. Transf\u00faze a hematologie dnes. 2014;20:67-75."},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Stegmayr B, Pt\u00e1k J, Wikstrom B, et al. World apheresis registry 2003-2007 data. Transfus Apher Sci. 2008;39(3):247-254.","DOI":"10.1016\/j.transci.2008.09.003"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Bl\u00e1ha M, L\u00e1nsk\u00e1 M, Tom\u0161ov\u00e1 H, \u017d\u00e1k P. Apheresis data registration in WWA registry-10-year experience of our center. Transfus Apher Sci. 2017;56(5):738-741.","DOI":"10.1016\/j.transci.2017.08.024"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"Bl\u00e1ha M, Pt\u00e1k J, \u010c\u00e1p J, et al. WAA apheresis registry in the Czech Republic: two centers experience. Transfus Apher Sci. 2009;41(1):27-31.","DOI":"10.1016\/j.transci.2009.05.005"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"Witt VB, Stegmayr J, Ptak J, et al. World apheresis registry data from 2003 to 2007, the pediatric and adolescent side of the registry. Transfus Apher Sci. 2008;39(3):255-260.","DOI":"10.1016\/j.transci.2008.09.001"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Mortzell M, Berlin G, Nilsson T, et al. Analyses of data of patients with Thrombotic Microangiopathy in the WAA registry. Transfus Apher Sci. 2011;45(2):125-131.","DOI":"10.1016\/j.transci.2011.07.001"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Stegmayr B, Pt\u00e1k J, Nilsson T, et al. Panorama of adverse events during cytapheresis. Transfus Apher Sci. 2013;48(2):155-156.","DOI":"10.1016\/j.transci.2013.02.014"},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"Kojima S, Yoshitomi Y, Sotaome M, et al. Effects of losartan on low-density lipoprotein apheresis. Ther Apher.1999;3(4):303-306.","DOI":"10.1046\/j.1526-0968.1999.00195.x"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"Kojima S, Shida M, Takano H, et al. Effects of losartan on blood pressure and humoral factors in a patient who suffered from anaphylactoid reactions when treated with ACE inhibitors during LDL apheresis. Hypertens Res. 2001;24(5):595-598.","DOI":"10.1291\/hypres.24.595"},{"key":"ref40","doi-asserted-by":"publisher","unstructured":"Winters JL. Low-density lipoprotein apheresis: principles and indications. Semin Dial. 2012;25(2):145-151.","DOI":"10.1111\/j.1525-139x.2011.01025.x"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"Pulido J. Multicenter Investigation of Rheopheresis for AMD (MIRA-1) study Group, Multicenter prospective, randomised, double-masced, placebo-controlled study of rheopheresis to treat nonexudative age-related macular degeneration: interim analysis, Trans. Am. Ophthalmol. Soc. 2002;100:85-107.","DOI":"10.1007\/978-3-7091-7985-7_18"},{"key":"ref42","unstructured":"Pulido JS, Winter JL, Boyer D. Preliminary analysis of the final multicenter investigation of rheopheresis for age related macular degeneration (AMD) trial (MIRAl) results, Trans Am Ophthalmol Soc. 2006;104:221-231."},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Bl\u00e1ha M, Rencov\u00e1 E, Langrov\u00e1 H, et al. Rheohaemapheresis in the treatment of nonvascular age-related macular degeneration. Atheroscler Suppl. 2013;14(1):179-184.","DOI":"10.1016\/j.atherosclerosissup.2012.10.023"},{"key":"ref44","doi-asserted-by":"publisher","unstructured":"Sikorski BL, Bukowska L, Kaluzny JJ, et al. Drusen with accompanying fluid underneath the sensory retina. Ophthalmology. 2011;118:82-92.","DOI":"10.1016\/j.ophtha.2010.04.017"},{"key":"ref45","doi-asserted-by":"publisher","unstructured":"Khanifar AA, Koreishi AF, Izatt JA, Toth CA. Drusen ultrastructure imaging with spectral domain optical coherence tomography in age-related macular degeneration, Ophthalmology. 2008;115:1883-1890.","DOI":"10.1016\/j.ophtha.2008.04.041"},{"key":"ref46","doi-asserted-by":"publisher","unstructured":"Bl\u00e1ha M, Krejsek J, Bl\u00e1ha M, et al. Selectins and monocyte chemotactic peptide as the markers of atherosclerosis activity, Physiol Res. 2004;53(3):273-278.","DOI":"10.33549\/physiolres.930460"},{"key":"ref47","doi-asserted-by":"publisher","unstructured":"Michelson AD, Barnard MR, Hechtman HB, et al. In vivo tracking of platelets: circulating degranulated platelets rapidly lose surface P-selectin but continue to circulate and fiction. Proc Natl Acad Sci USA. 1996;93(21):11877-11882.","DOI":"10.1073\/pnas.93.21.11877"},{"key":"ref48","doi-asserted-by":"publisher","unstructured":"Julius U, Milton M, Stoellner D, et al. Effects of lipoprotein apheresis on PCSK9 levels. Atherosclerosis Supplements. 2015;18:180-6.","DOI":"10.1016\/j.atherosclerosissup.2015.02.028"},{"key":"ref49","unstructured":"Bl\u00e1ha M, Sko\u0159epov\u00e1 M, Ma\u0161\u00edn V, et al. The role of erythrocytapheresis in secondary erythrocytosis therapy. Clin Hemorheol Microcirc. 2002;26(4):273-275."}],"container-title":["Czech and Slovak Ophthalmology"],"original-title":[],"language":"en","deposited":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T13:42:44Z","timestamp":1688737364000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.cs-ophthalmology.cz\/en\/journal\/articles\/266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,20]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,2,20]]},"published-print":{"date-parts":[[2023,2,20]]}},"URL":"https:\/\/doi.org\/10.31348\/2023\/2","relation":{},"ISSN":["1805-4447","1211-9059"],"issn-type":[{"value":"1805-4447","type":"electronic"},{"value":"1211-9059","type":"print"}],"subject":[],"published":{"date-parts":[[2023,2,20]]}}}