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Impressum
Brimonidine 0,2% as additive therapy to hemodilution in patients with nonarteriitic ischemic optic neuropathy: A prospective randomisied trial.
Kono Kono J. O., Bergmann M.,. Klopfer M., Wegner A., Lanzl I., Schmidt T.
Augenklinik der TU München, Ismaninger Str. 22, 81675 München
Background: We prospectively investigated the effect of Brimonidine
0.2% on funtional optic nerve restitution in patients with nonarteriitic
ischemic optic neuropathy (AION).
Patients and Methods: 28 patients ranging in age from 55 to 85
years (mean 66.3 years) with AION were recruited for this trial. The duration
of follow-up was between 8 und 16 months (mean 13.3 months). 14 patients
received topical Brimonidine 0,2% twice a day in the affected eye for
3 months and 14 patients did not receive any topical drugs. All patients
received an iso- or hypervolemic hemodilution with daily infusion of pentoxifylline
(100-300 mg) in 250 ml Hydroxyethyl-starch 6% over 10 days. Pentoxifylline
was also given p.o. for 3 months. Visual acuity, VEP and visual field
were mesured on the first day and at the end of follow-up.
Results: 11 patients (39,2%) of the study group experienced an
improvement of central visual acuity by 2 or more lines, 10 (37,7%) a
deterioration and 7 (25%) remained unchanged. During the follow-up, no
recurrence was registered and the second eye was affected in one case
(3,5%). Neither visual acuity, nore VEP, nore visual field were significantly
changed in the groups with and without Brimonidine therapy (P>0.05).
Conclusion: Hemodilution with Hydroxyethyl-starch/pentoxifylline
seems to decrease the rate of recurrence in the affected eye and the imvolvement
of the second eye. Brimonidine 0.2% has no significant effect on visual
acuity, VEP and visual field after AION. This does not rule out the neuroproctetive
effect of Brimonidine in patients with nonarteriitic ischemic optic neuropathy.
Further trials including more patients are warranted to verify our results.