Imminent blindness comparable to state of emergency

17. March 2022

Imminent blindness is a situation comparable to a state of emergency

Retinitis Pigmentosa: Health insurance company must retroactively cover costs for OkuStim therapy

A recent ruling by a German social court (Landessozialgericht Niedersachsen-Bremen, LSG) paves the way for the retroactive reimbursement of OkuStim therapy for retinitis pigmentosa (RP). A patient had filed a lawsuit because her health insurance company refused to cover the costs on the grounds that an imminent blindness was not to be expected and that the therapeutic benefit of TES had not yet been evaluated by the Federal Joint Committee (G-BA).

The LSG justified its decision on the basis that the concrete prognosis period for RP could not be determined. Accordingly, the irreversible loss of residual vision and the threat of blindness itself constitute a situation comparable to an emergency, even if the point in time at which the irreparable damage occurs cannot be predicted. With a narrowing of the plaintiff’s field of vision to 10°, the disease had reached a stage where further waiting would no longer be reasonable. Transcorneal electrical stimulation (TES) with the OkuStim system would no longer have any medical benefit for the plaintiff at a later stage. The plaintiff’s health insurance fund must now reimburse the costs for the purchase of the OkuStim system and cover her future therapy costs.

The plaintiff had unsuccessfully applied to her health insurance company in December 2017 for the costs of OkuStim therapy to be covered. At that time, she still had a visual field of 10 degrees and a visual acuity of 0.8. In the meantime, the plaintiff had started the OkuStim therapy at her own expense. Following a medical opinion, the Regional Social Court stated in the reasons for the ruling that the TES had already had a noticeable positive effect on the course of the disease.

With the OkuStim therapy, the progressive loss of the visual field in retinitis pigmentosa can be slowed down. In an ongoing trial commissioned by the G-BA, the effectiveness and long-term benefit of the therapy are being investigated. Only with a positive benefit assessment can a regular coverage of the therapy costs by the health insurance companies take place. For self-payers, the CE-marked OkuStim system is available through clinical competence centres in several European countries.

Electrical Stimulation as Therapy Option for RP

7. October 2021

Electrical Stimulation: as Therapy Option for RP

New ophthalmology guideline recommends electrical stimulation for retinitis pigmentosa

In the amendment of their guideline 25 (now guideline AWMF 045/23) for hereditary retinal, choroidal and visual pathway diseases, the German Ophthalmological Society (DOG), the Retinological Society (RG) and the Professional Association of Ophthalmologists of Germany (Berufsverband der Augenärzte Deutschlands e.V., BVA) refer to electrostimulation as an option for the treatment of retinitis pigmentosa (RP). The text also mentions the large-scale Federal Joint Comittee-appointed clinical investigation that began in May as a possible application context.

Thanks to the revision of the guideline, ophthalmologists now have concrete options for the symptomatic treatment of hereditary retinal dystrophies with electrostimulation in RP and gene therapy in LCA.

You can download the original text of the guideline in German as a PDF file:

– from the website of the Retinological Society
– from the website of the German Ophthalmological Society.

Find our more about the efficacy and safety of the Okutim therapy:

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