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Application of HELP in nonarteritic anterior ischemic optic neuropathy: A prospective, randomized, controlled study

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Abstract

• 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 calculated mean 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.

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Authors and Affiliations

  1. Department of Ophthalmology, Karl-Franzens University of Graz, Auenbruggerplatz 4, A-8036, Graz, Austria

    Anton Haas, Friedrich Jesenik, Jutta Berglöff, Beatrix Feigl & Jürgen Faulborn

  2. Department of Electrobiology, Karl-Franzens University, Graz, Austria

    Manfred Walzl & Berengaria Walzl

  3. Institute of Medical Informatics, Statistics and Documentation, Karl-Franzens University, Graz, Austria

    Andrea Berghold

Authors
  1. Anton Haas
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  2. Manfred Walzl
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  8. Jürgen Faulborn
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Haas, A., Walzl, M., Jesenik, F. et al. Application of HELP in nonarteritic anterior ischemic optic neuropathy: A prospective, randomized, controlled study. Graefe's Arch Clin Exp Ophthalmol 235, 14–19 (1997). https://doi.org/10.1007/BF01007832

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  • DOI: https://doi.org/10.1007/BF01007832

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