Preservation of the Photoreceptor Inner/Outer Segment Junction in Dry Age-Related Macular Degeneration Treated by Rheohemapheresis

Figure 3

(a) SD-OCT of the same left eye shown in Figure 2(a), taken 2.5 years after rheohemapheresis treatment. Dry form of AMD. In addition to the perfect attachment of the original DPED, there is evident attachment and restoration of the previously detached and degeneratively damaged photoreceptor IS/OS junction, with the exception of two small defects in the central fovea and to the left of it (these defects are located between both the left and right pair of arrows). To the right of the central defect, there is also a small portion of the IS/OS junction which is not visible because it becomes a part of the vertically oriented optical shadow under a dense particle. The remainder of the original junction degeneration is offset towards the inner part of the retina into its plexiform layer. The abovementioned vertical optical shadow does not preclude the presence of the junction section already attached to its intact neighboring sections. Clear morphologic rectification of the position and structure of the photoreceptor IS/OS junction corresponds to the restoration of visual acuity of this eye (BCVA 20/25 (0.8) and improvement of mfERG). (b) Multifocal electroretinogram—responses after RHF. Superposition of mfERG responses to the fundus of the left eye of the patient from (a). (c) A three-dimensional image of the electrical activity of the retina after RHF. Left: A three-dimensional image of the electrical activity of the retina of the left eye of the patient from (a) with increased parafoveal activity, compared to the normal-for-age image on the right (increase of parafoveal activity moves back into the normal range, illustrated by the change from grey depressions to green columns in the parafoveal region).

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