Florida doctor is investigated over experimental treatment

A doctor who claims that apheresis or plasmapheresis is beneficial in age related macular degeneration is being investigated by the Florida Agency for Health Care Administration.

Dr Richard Davis is the owner of Rheotherapy Centers of Largo, on Florida's west coast, which offers plasmapheresis sessions, each costing $1800-$2200 (£1100-£1400), to elderly patients with macular degeneration.

Dr Davis faces a hearing before the Florida Board of Medicine on charges of “false, deceptive or misleading advertising … of Rheotherapy as a safe and effective treatment, when Rheotherapy is an experimental procedure” and on charges of practising medicine below the appropriate standard of care. The Board of Medicine could revoke or suspend Dr Davis's licence to practise medicine.

The Florida Agency for Health Care Administration issued an emergency order in January closing the Rheotherapy Centres, allegedly after ophthalmologists complained that plasmapheresis treatment of macular degeneration had no scientific basis. But the agency rescinded its order and allowed the centre to reopen after phone calls from patients who claimed the treatment had helped them. After Dr Davis presented his case to the agency in Tallahassee, he was ordered to explain to patients that the treatment was only experimental and not reimbursed by Medicare or private health insurance. He was also ordered to accept monitoring of his clinic's operation by agency approved specialists.

Dr Davis said that two years ago he visited Dr Richard Brunner, a professor of ophthalmology at the University of Cologne in Germany. Dr Brunner has published work on plasmapheresis as a treatment for macular degeneration but has not carried out a controlled clinical trial.

Dr Davis said that plasmapheresis machines have been approved by the Food and Drug Administration and can thus be used to treat any condition without restriction. He said that he has treated over 100 patients, and 90% of them had improved. After treatment patients report increased brightness of vision, a return of colour vision, and the disappearance of wavy lines. The central scotoma, a prominent feature of macular degeneration, breaks up, with improved central vision. Patients are also followed by their own ophthalmologists, who have reported improvement in 60% of patients.

However, Dr Philip Rosenfeld, associate professor of ophthalmology at Bascom Palmer Eye Center, University of Miami School of Medicine, said, “These guys are charging people $20000 for a treatment that doesn't work.”

Dr Davis denounced his professional critics, and said, “I have introduced a totally radical new idea. It's unconventional and very threatening.”

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