Accelerated reperfusion of poorly perfused retinal areas in central retinal artery occlusion and branch retinal artery occlusion after a short treatment with enhanced external counterpulsation.
BACKGROUND
To date, no satisfactory therapy has become available for patients with acute central retinal artery occlusion (CRAO) or branch retinal artery occlusion (BRAO). Enhanced external counterpulsation (EECP) is a new noninvasive procedure that increases perfusion of inner organs. In the current study, the authors measured the impact of EECP on reperfusion in ischemic retinal tissue.


METHODS
In a prospective, randomized study, 20 patients with CRAO or BRAO were included. Ten patients were given hemodilution therapy and 2 hours of EECP, and 10 patients were given regular hemodilution therapy only. Quantification of changes in retinal perfusion was carried out by means of scanning laser Doppler flowmetry (in arbitrary units).


RESULTS
Enhanced external counterpulsation caused no observable adverse events. A significant increase in perfusion occurred immediately after EECP in the ischemic retinal areas (57 +/- 19 arbitrary units versus 99 +/- 14 arbitrary units). In contrast, no change was measured in the group not treated with EECP (83 +/- 19 arbitrary units versus 89 +/- 44 arbitrary units). Forty-eight hours later, a significant increase in perfusion could be shown in the ischemic retina of both groups, and no significant difference of perfusion was found between the two groups any longer.


CONCLUSIONS
The current study suggests that EECP could be a clinically useful and safe procedure in patients with CRAO or BRAO to accelerate recovery of perfusion in ischemic retinal areas.
II Medical Department (Cardiology and Angiology), Friedrich-Alexander-University, Erlangen-Nuremberg, Germany. Dierk.Werner@nexgo.de
Dierk
D
Werner
Fabian
F
Michalk
Joanna
J
Harazny
Claudia
C
Hugo
Werner G
WG
Daniel
Georg
G
Michelson
D000368:Aged; D015908:Counterpulsation / Q000379:methods*; D005260:Female; D006438:Hemodilution / Q000379:methods; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow; D015424:Reperfusion / Q000379:methods*; D015427:Reperfusion Injury / Q000503:physiopathology / Q000628:therapy; D012160:Retina / Q000503:physiopathology*; D015356:Retinal Artery Occlusion / Q000503:physiopathology* / Q000628:therapy*; D014792:Visual Acuity