Three episodes of non-arteritic posterior ischemic optic neuropathy in the same patient treated with intravenous prostaglandin E1

Steigerwalt, Robert D; Pascarella, Antonella; Angelis, Mauro De; Grimaldi, Gabriela; Nebbioso, Marcella

doi:10.5582/ddt.2016.01036

Cited by 5 publications

(10 citation statements)

References 12 publications

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“…In cases of NA-PION, PGE1 was given intravenously at a dose of 1 μg/kg with steroids and was found to improve visual acuity as well as ocular and retrobulbar blood flow (4,5). In the current case, visual fields as well as visual acuity were improved in a patient with NA-PION treated with intravenous PGE1 and steroids 66 hours after onset.…”

Section: Introductionmentioning

confidence: 59%

“…This paralleled the improvement in the visual acuity from 1/10-to 7/10 + 1, which is consistent with her age-related macular degeneration. In another case of NA-PION, vision improved to 11/10 with no central scotoma on visual fields tested only after treatment (5). In that case, treatment was administered within 24 hours and there was no age-related macular degeneration.…”

Section: Discussionmentioning

confidence: 99%

“…The use of a potent vasodilator, PGE1, to immediately re-establish blood flow could be important (3,7). PGE1 given intravenously at a dose of 1 μg/kg together with steroids has been successfully used to treat cases of NA-PION and acute non-arteritic anterior ischemic optic neuropathy (NA-AION) (4,5,8). PGE1 has helped in the treatment of acute arteritic anterior ischemic optic neuropathy when given with high-dose steroids (9).…”

Section: Discussionmentioning

confidence: 99%

“…Ischemic episodes in NA-AION and NA-PION are known to reoccur in the affected eye or in the other eye (5,11). To avoid another episode in the good eye, the authors wanted to maintain vasodilatation of the microcirculation with PGE1 without resorting to intravenous treatments.…”

Section: Discussionmentioning

confidence: 99%

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Visual field improvement in non-arteritic posterior ischemic optic neuropathy in a patient treated with intravenous prostaglandin E1 and steroids

Steigerwalt¹,

Limoli²,

Nebbioso

2017

DD&T

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Section: Introductionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Visual field improvement in non-arteritic posterior ischemic optic neuropathy in a patient treated with intravenous prostaglandin E1 and steroids

Steigerwalt¹,

Limoli²,

Nebbioso

2017

DD&T

Self Cite

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“…The authors normally use i.v. PGE1 for acute ocular ischemia (3)(4)(5)(6) and would have preferred that here. With i.v.…”

Section: Discussionmentioning

confidence: 99%

Visual improvement in a patient with paracentral acute middle maculopathy treated with prostaglandin E1

Steigerwalt¹,

Nebbioso

2020

DD&T

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paracentral acute middle maculopathy, acute retinal ischemia, prostaglandin E1 The authors present the use of prostaglandin E1 (PGE1) for the treatment of an acute paracentral acute middle maculopathy (PAMM). A 78-year-old white female was seen with a sudden loss of vision in her left eye (OS) to 20/200 noted upon awakening. The right eye (OD) saw 20/20. A complete eye exam was done and an ocular coherent tomography revealed retinal thickening and a whitening of the inner nuclear layer in the area of the macula OS. A diagnosis of PAMM in the OS was made. Treatment was immediately started with 70 μg of PGE1 administered over 1.5 hours in the form of a skin cream. A volume of 3.5 cc of skin cream was applied in divided doses to the inner surface of the forearm, rubbed into the skin and allowed to dry. The same 70 μg of PGE1 in 3.5 cc of skin cream was repeated once the next morning. The patient began to see better the second day of treatment with a final visual acuity of 20/20. The OD was unchanged. After 14 months she was stable with no further treatment. PAMM is an ischemic process of the inner retina. PGE1, a potent vasodilator of the microcirculation, when given immediately seemed to be useful in restoring vision in this form of retinal ischemia. Treatment was immediately started with PGE1 in the form of a skin cream with visual improvement. The authors normally use PGE1 intravenously for acute ocular ischemia and would have preferred that here. Intravenous PGE1 was not available and was substituted with the skin cream of PGE1 that worked well for the patient.

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Documented Reperfusion of the Retina on Fluorescein Angiography after Administration of Intravenous Prostaglandin E1 for Central Retinal Artery Occlusion: A Case Report

Chacko,

Broyles,

Chacko

et al. 2023

Case Rep Ophthalmol

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Central retinal artery occlusion (CRAO) can result in devastating permanent vision loss. Presently, there is no evidence-based treatment for CRAO that is widely accepted. In the literature, multiple studies propose intravenous (IV) prostaglandin E1 (IV PGE1) as a potential treatment option for patients with CRAO. We illustrate 2 cases of CRAO successfully treated with IV PGE1. In both cases, our patients with vascular risk factors were diagnosed with CRAO of the left eye. They were started on twice daily IV 40 μg PGE1 in 100 mL normal saline, with each dose administered over 3 h. In the first case, we documented reperfusion of the retina on fluorescein angiography after administration of IV PGE1. In the second case, our patient improved from no light perception visual acuity (VA) to count fingers VA within 48 h of treatment with IV PGE1. Our study highlights the vasodilatory effect of IV PGE1. Due to its mechanism of action and safety profile, it should be considered a potential treatment option for CRAO. Further randomized controlled trials are necessary to determine the overall therapeutic effect of IV PGE1 for CRAO.

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Three episodes of non-arteritic posterior ischemic optic neuropathy in the same patient treated with intravenous prostaglandin E1

Cited by 5 publications

References 12 publications

Visual field improvement in non-arteritic posterior ischemic optic neuropathy in a patient treated with intravenous prostaglandin E1 and steroids

Visual field improvement in non-arteritic posterior ischemic optic neuropathy in a patient treated with intravenous prostaglandin E1 and steroids

Visual improvement in a patient with paracentral acute middle maculopathy treated with prostaglandin E1

Documented Reperfusion of the Retina on Fluorescein Angiography after Administration of Intravenous Prostaglandin E1 for Central Retinal Artery Occlusion: A Case Report

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