Three episodes of non-arteritic posterior ischemic optic neuropathy in the same patient treated with intravenous prostaglandin E1.
Non-arteritic posterior ischemic optic neuropathy (NA-PION) is a disorder involving reduced blood flow to the retrobulbar portion of the optic nerve. This disorder usually develops acutely, and research has suggested that high-dose steroid therapy soon after the onset of visual loss can result in significant visual improvement. This treatment, however, is not universally successful. The addition of a potent vasodilator could help to restore ocular blood flow. This case report describes the use of prostaglandin E1 (PGE1), a powerful vasodilator of the microcirculation, to treat three separate episodes of NA-PION over five years in the same patient. A 68-year-old white male was first seen in June 2009 with NA-PION in the left eye, and the condition was treated with steroids and PGE1. The patient had a subsequent episode in July 2010 that was treated with steroids and PGE1 and another in May 2014 that was treated with PGE1 alone. Visual acuity improved from 4/10 to 11/10 in 2009, from 4/10 to 11/10 in 2010, and from 5/10 to 10/10 in 2014. No complications due to the use of PGE1 were noted. PGE1 should be considered as a treatment for NA-PION to immediately restore blood flow and potentially improve vision.
Via A. Brofferio 6.
Robert D
RD
Steigerwalt
Antonella
A
Pascarella
Mauro
M
De Angelis
Gabriela
G
Grimaldi
Marcella
M
Nebbioso
D000368:Aged; D000527:Alprostadil / Q000009:adverse effects* / Q000627:therapeutic use*; D006432:Hemochromatosis / Q000150:complications / Q000235:genetics; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D018917:Optic Neuropathy, Ischemic / Q000139:chemically induced* / Q000000981:diagnostic imaging; D012161:Retinal Artery / Q000187:drug effects; D015356:Retinal Artery Occlusion / Q000188:drug therapy; D018615:Ultrasonography, Doppler, Color; D014665:Vasodilator Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D014792:Visual Acuity / Q000187:drug effects
D014665:Vasodilator Agents; D000527:Alprostadil