[Therapeutic follow-up using automatic perimetry in chronic cerebroretinal ischemia in elderly patients. Prospective double-blind study with graduated dose ginkgo biloba treatment (EGb 761)].
The chronic cerebral retinal insufficiency syndrome in elderly patients is an organ specific expression of a generalized vascular cerebral deficiency. The progress of the disease is characterized by complex symptoms, variation in course, spontaneous remissions and, until recently inadequate diagnostic measurement methods. The new method of automated perimetry with the octopus 2000 P offers a patient-friendly procedure for indirect non-invasive diagnosis of circulatory state in limited cerebral retinal perfusion. In the present study measurements were made with this method on 24 patients (4 men and 20 women with an age of 74.9 +/- 6.9 years). The effect of the extract of Ginkgo biloba (EGb 761) on the reversibility of visual field disturbances was tested using a randomized and double blind study-design in two phases and with two dose levels. The main parameter investigated in this study was the change in the luminous density difference threshold after therapy with EGb 761. In group B (EGb 761 dose 160 mg/day) a significant increase in retinal sensitivity was seen within 4 weeks (p less than 0.05). In the lower dose (80 mg EGb 761/day) group (A), this change in retinal sensitivity was first seen after increasing the dose to 160 mg/day (p less than 0.01). The relative sensitivity of damaged retinal areas was more strongly influenced than "healthy" areas. The assessment by both doctors and patients of the general condition of the patients showed a significant improvement after the course of therapy. The results presented here show that damage to the visual field by chronic lack of bloodflow are significantly reversible.(ABSTRACT TRUNCATED AT 250 WORDS)
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D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy*; D003118:Color Perception / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D020441:Ginkgo biloba; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D010936:Plant Extracts / Q000627:therapeutic use*; D011446:Prospective Studies; D012029:Refraction, Ocular; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy*; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D014792:Visual Acuity / Q000187:drug effects; D058609:Visual Field Tests / Q000295:instrumentation*; D000096983:Ginkgo Extract
D010936:Plant Extracts; C063170:Ginkgo biloba extract; D000096983:Ginkgo Extract
Therapieverlaufskontrolle mittels automatisierter Perimetrie bei chronischer zerebroretinaler Mangelversorgung älterer Patienten. Prospektive randomisierte Doppelblinduntersuchung mit dosisgestaffelter Ginkgo biloba-Behandlung (EGb 761).