A Case Report of Double-Filtration Plasmapheresis for the Treatment of Age-related Macular Degeneration

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Abstract

An 85-year-old man with dry type age-related macular degeneration (AMD) in his right eye and a disciform scar in his left eye received double-filtration plasmapheresis (DFPP) for the treatment of his right eye. The protocol for plasmapheresis followed the Multicenter Investigation of Rheopheresis for AMD (MIRA) trial and consisted of four pulses of paired sessions of plasmapheresis with a two-day interval within 10 weeks. The pre-DFPP best corrected visual acuity (BCVA) for the right eye was 6/15 (0.4). Six months after DFPP treatment, the BCVA of the right eye was 6/10 (0.6) and remained unchanged at the 12th month; however, comparison of the right eye fundus picture, fluorescein angiogram, and optical coherence tomography of the macular area before and 6 and 12 months after plasmapheresis revealed no discernable changes. The per-session and per-course clearance rates were highest for IgM (63.8% and 90.8%) and lowest for albumin (11% and 15.4%). No plasmapheresis-related complications, such as hypotension, hemolysis or infection, occurred. Thus, DFPP treatment can provide effective treatment for dry type AMD with minimal side-effects.

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