Abstract
Purpose:
To measure the safety and potential efficacy of MCS therapy for typically untreatable retinal diseases that include end stage macular degeneration and proliferative diabetic retinopathy (PDR), retinitis pigmentosa (RP).
Methods:
Thirty two patients placed in four groups; 22 with end stage dry macular degeneration; 4 with wet macular degeneration; 3 with PDR; 3 with RP with a mean age of 72.4 ± 15.3 (range 41 to 95 years) were prospectively enrolled this study. The transcutaneous electrical stimulation was applied using an FDA and CE Mark approved electrical stimulation device. The current was delivered in the micro Amp range with alternating polarizing frequencies at 100-150 μA for 36 minutes. Subjective improvement in daily function was evaluated with a standardized pre and post treatment questionnaire and objective ETDRS visual acuity was obtained.
Results:
The mean average improvement based on the ETDRS score was 5.60±7.64. Overall, 67% showed a modest (0-5 ETDRS letters) to marked (equal to or greater than 10 ETDRS letters) increase in subjective vision function and objective ETDRS visual acuity following therapy. No ocular nor systemic adverse effects were observed within this population. Of the 22 dry macular degeneration patients, 16 reported subjective visual improvements (72%) and had an average improvement of 6.37±8.80. Two of the four patients with wet macular degeneration reported a subjective visual improvement (50%) and have an average improvement of 4.00±2.60. Two of the three patients with RP reported a subjective visual improvement (67%) and have an average improvement of 3.16±4.37. Two of the three patients with PDR reported a subjective visual improvement (67%) and have an average improvement of 4.50±2.20.
Conclusions:
MCS therapy is a non-invasive procedure, which involves transcutaneous with very low intensity electrical current. It is hypothesized that MCS’s mechanism of action is to increase intracellular adenosine triphosphate (ATP), thereby enhancing protein synthesis and modulating neural group polarizing response. Although the majority of the patients demonstrated both subjective and objective improvement, the effect was short lived and determination of efficacy is limited. This pilot study suggests that MCS can be safely administered to this population; however long-term controlled trials are indicated.
Keywords: 688 retina •
701 retinal pigment epithelium •
584 low vision