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Medline ® Abstract for Reference 67

of 'Nonarteritic ischemic optic neuropathy: Prognosis and treatment'

Application of HELP in nonarteritic anterior ischemic optic neuropathy: a prospective, randomized, controlled study.
Haas A, Walzl M, Jesenik F, Walzl B, Berghold A, Berglöff J, Feigl B, Faulborn J
Graefes Arch Clin Exp Ophthalmol. 1997;235(1):14.
BACKGROUND: 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 calculatedmean 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.
Department of Ophthalmology, Karl-Franzens University of Graz, Austria.