Prediction of long-term prognosis of age-related macular degeneration treated by hemorheologic therapy using baseline laboratory indicators - Experimental-clinical model
Affiliations: [a] 4th Department of Internal Medicine – Haematology, University Hospital and Faculty of Medicine Hradec Kralove, Hradec Kralove, Czech Republic
| [b] Department of Ophthalmology, University Hospital and Faculty of Medicine Hradec Kralove, Hradec Kralove, Czech Republic
| [c] III. Internal Gerontometabolic Clinic, University Hospital and Faculty of Medicine Hradec Kralove, Hradec Kralove, Czech Republic
| [d] Department of Clinical Immunology and Allergology, University Hospital and Faculty of Medicine Hradec Kralove, Hradec Kralove, Czech Republic
| [e] Centre for Experimental Medicine, Laboratory for Atherosclerosis Research, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| [f] Department of Ophthalmology, Liberec Hospital, Liberec, Czech Republic
Correspondence:
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Corresponding author: Eva Vejrazkova, 4th Department of Internal Medicine, Haematology of University Hospital and Faculty of Medicine Hradec Kralove, Sokolska 581, 50005 Hradec Kralove, Czech Republic. Tel.: +420495832686; Fax: +420495832011; E-mail: eva.vejrazkova@fnhk.cz.
Abstract: BACKGROUND + OBJECTIVE:Age-related macular degeneration (AMD) is the most common cause of practical blindness in people over 60 years of age in industrialised countries. We formulated a hypothesis that a group of initial laboratory parameters would be suitable for prediction of prognosis of AMD, allowing for individual modifications in treatment intensity. PATIENTS AND METHODS:66 patients with dry form of AMD were treated using rheohaemapheresis with an individual follow-up period of more than 5 years. The patients’ initial laboratory data was split in two subgroups based on treatment success and analysed using discriminant analysis (analysis of the linear and quadratic models using the automated and interactive step-wise approach) by means of the Systat 13 software. RESULTS:Prediction of prognosis based on the initial laboratory parameters was correct in 79% of unsuccessfully treated patients, allowing for early detection of high-risk patients. With the use of a quadratic model, the prediction was correct in 100% of unsuccessfully treated patients and in 75% of successfully treated patients. CONCLUSION:Implementation of discriminant analysis is a promising method for prediction of prognosis, especially when the patient is at risk of AMD progression, which allows for early and more intensive monitoring and treatment.
