Systemic prostaglandin E1 to treat acute central retinal artery occlusion.

Abstract

PURPOSE:

To report the efficacy of systemic prostaglandin E1 (PGE1) monotherapy for treating acute central retinal artery occlusion (CRAO).

METHODS:

The best-corrected visual acuity (BCVA) and side effects were evaluated retrospectively in 10 consecutive eyes (nine patients; mean age, 61.3 years) with acute CRAO treated with PGE1 monotherapy. The protocol included intravenous injection of 40 μg PGE1 twice daily (80 μg per day) for 5 days then oral PGE1 three times daily (30 μg per day) for at least 1 month. In four eyes, the retinal vessel diameters were assessed on serial fundus photographs.

RESULTS:

The mean time to treatment was 7.1 hours (range, 1-18 hours). The mean ± SD logarithm of the minimum angle of resolution (logMAR) BCVAs at baseline and 1 month after initiation of therapy were 2.67 ± 0.54 (range, 3.00-1.70) and 0.52 ± 0.62 (range, 2.00 to -0.18), respectively (P = 0.005); the BCVA improved by 1.0 or more logMAR unit at 1 month in all eyes. The BCVA improvement was correlated negatively with the time to treatment (ρ = -0.655, P = 0.0492), but was not correlated with age (ρ = -0.473, P = 0.156) and did not differ between sexes (P = 0.0871). Compared with baseline, the mean changes in the vessel diameters in four cases were 151.1% (range, 115.1%-188.0%) in the arteries and 191.0% (range, 127.2%-246.4%) in the veins 1 day after initiation of therapy. Angialgia during injection was the only side effect.

CONCLUSIONS:

Systemic administration of PGE1 for acute CRAO rapidly restores retinal blood flow by its vasodilatory effects, improves VA, is well tolerated with few side effects, and requires no special training.

• Authors: Yasuyuki Takai, Masaki Tanito, Yotaro Matsuoka, Katsunori Hara, Akihiro Ohira
• Journal: Investigative ophthalmology & visual science (Invest Ophthalmol Vis Sci) Vol. 54 Issue 4 Pg. 3065-71 (Apr 30 2013) ISSN: 1552-5783 [Electronic] United States
• PMID: 23580487 (Publication Type: Journal Article)

Chemical References

• Vasodilator Agents
• Alprostadil

Topics

• Administration, Oral
• Aged
• Alprostadil (therapeutic use)
• Drug Administration Schedule
• Female
• Humans
• Injections, Intravenous
• Male
• Middle Aged
• Retinal Artery Occlusion (drug therapy)
• Retinal Vessels (pathology)
• Retrospective Studies
• Time-to-Treatment
• Vasodilator Agents (therapeutic use)
• Visual Acuity