✍ Scribed by Jose S. Pulido; Jeffrey Winters
No coin nor oath required. For personal study only.
Recently there has been increased interest in the use of rheopheresis in patients with nonexudative age-related macular degeneration (AMD). In part, this is because Canada has approved the use of this treatment for macular degeneration. Unfortunately, the approval was in large part based on the early results of a randomized controlled trial [1]. We do not believe that this is sufficient data to justify and recommend the use of this form of treatment outside of the randomized controlled trial. The initial data are of interest and allowed the progression of the trial but do not justify the use since the data at the end may not continue to show the same results.
Nonexudative age-related macular degeneration is a frustrating disease to treat. At the present time, the use of certain vitamins and zinc and copper as well as stopping smoking seem to be the best way of preventing progression [2]. Recent data suggest that other treatments may be of help as well including the use of statins, the use of aspirin, and the controlling of cholesterol [2-4]. There appears to be a relationship between an allelic variant of complement factor H and AMD in about 50% of cases [5]. This would help to validate the importance of tempering an inflammatory response in this condition. So though the data at this time for rheopheresis is intriguing and promising, we do not recommend its use outside of randomized controlled trials.
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