title: Systemic prostaglandin E1 to treat acute central retinal artery occlusion.
abstract: OBJECTIVE
  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.affiliation: Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Japan. takai611@med.shimane-u.ac.jp
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Takai
authors.forename: Masaki
authors.initials: M
authors.lastname: Tanito
authors.forename: Yotaro
authors.initials: Y
authors.lastname: Matsuoka
authors.forename: Katsunori
authors.initials: K
authors.lastname: Hara
authors.forename: Akihiro
authors.initials: A
authors.lastname: Ohira
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000527:Alprostadil / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D015356:Retinal Artery Occlusion / Q000188:drug therapy*; D012171:Retinal Vessels / Q000473:pathology; D012189:Retrospective Studies; D061665:Time-to-Treatment; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014792:Visual Acuity
chemical_list: D014665:Vasodilator Agents; D000527:Alprostadil