Drusen

Dr. Wylie, from Seattle Washington, presents a study showing reduction of Drusen after Bemer therapy.

(watch an interesting update video following this study!)

Case Presentation: Dry Macular Degeneration and Bemer Vascular Therapy

The CDC (Centers for Disease Control and Prevention) notes macular degeneration is the leading cause of vision loss in the United States for people 65 years and older. With the continued aging of the population in the United States and Europe, AMD (age-related macular degeneration) will continue to affect a larger and larger number of people around the world. Presently AMD is considered an incurable disease.

Macular degeneration is a complex disease with many possible contributing factors. Genetics are a well-recognized risk factor. Other risk factors are controllable: smoking, being overweight, uncontrolled high blood pressure and cardiovascular disease. Long term exposure to sun light without eye protection can be another contributor.

The macula is the central area of the retina that is solely responsible for the ability to see fine detail. This is crucial for reading and driving. There are two types of AMD, wet and dry. 85-90% of AMD is the dry form. The macular tissue thins and begins to break down over time. A very common appearance with the dry form is drusen. Drusen are yellow or white lipid (fatty protein) deposits under the light receptive part of the retina. When the drusen are scattered, small and hard (clearly defined) their presence are a lower risk factor for vision loss. However, “soft” drusen are typically larger, clumped closer together and significantly increase the chance of vision loss. This is the type of drusen we will be seeing in this case presentation.

Patient history:

71 year old female. Five year history of AMD. Medical history: Hashimoto’s thyroid disease for 20 years, gallbladder and appendix removed, Irritable Bowel Syndrome.
Best corrected visual acuity: Right eye 20/30-1, Left eye 20/30-1

Right eye Left eye

Note the significant drusen deposits in the macular area of each eye.
The extensive soft drusen is even more clearly seen by an OCT (ocular coherence tomography) which gives a side profile of the macular area at a micron level.

Fortunately the drusen has not significantly deposited under the central macula of each eye. However, prognosis is guarded with the large drusen on either side of each central macula.

Right eye Left eye

Treatment:

The retina has one of the highest metabolic needs of any tissue in the body. The macula has the highest metabolic need of the retina. The macula replaces cells every two days. The rationale to use Bemer vascular therapy was to attempt to increase micro circulation in the retina to see if this would help with the absorption of the drusen deposits. The patient started twice a day Bemer sessions at the end of October. The patient was next seen in our office 7 months later.
Best corrected visual acuity: Right eye 20/20-1 (was 20/30-1 seven months prior)

Right eye shows significant improvement in drusen deposits and corresponding improvement in visual acuity. To see such significant resolution of soft drusen deposits is extremely rare.

Though the right eye showed marked improvement in drusen reduction the left eye showed essentially no change. The patient added an additional one month of Bemer vascular therapy with the Bemer Spot to the left eye but no further change was noted.

Discussion:

As noted in the beginning of this paper, AMD is a complex disease with many factors contributing to the loss of macular function. This complexity of contributing factors is seen even within one patient. It is possible the long term thyroid disorder, long term digestive disorder and decreased ability to emulsify fats due to the removed gallbladder could have contributed to the drusen formation. What is unknown is why the right eye responded so well to the improved microcirculation and the left eye did not achieve the same results. Fortunately the patient’s quality of life has improved with the increase in visual acuity in the right eye. The significant reversal of soft drusen is a very, very positive sign for the patient’s long term macular health. The improvements documented above of drusen reduction are among the first reported in the literature. Further studies are warranted to determine the effects of Bemer vascular therapy on additional patients with AMD.

D. Todd Wylie, OD, FCOVD
Spokane, WA

dtw@cet.com

 

A recent talk by Dr. Wylie on Eyes