Effects of Pentoxifylline on Blood Flow in Patients with Non-Arteritic Ischemic Optic Neuropathy

Abstract

Purpose: To determine whether Doppler OCT can be used to measure retinal arteriole-derived ocular blood flow in patients with non-arteritic ischemic optic neuropathy (NAION), who are treated with pentoxifylline.

Methods: Seven affected eyes and two fellow eyes from five patients with NAION (one eye not measureable), all receiving pentoxifylline (a xanthine derivative that affects erythrocyte rheology), were examined with Doppler OCT. This group was compared to our previously published group of untreated NAION eyes (N=8) (Wang et al.; IOVS 52(2): 840, 2011) and normal eyes (n=10), (Wang, et al.; Br J Ophthalmol. May; 93(5): 634, 2009). Doppler OCT was performed using high-resolution Fourier domain-OCT scans and post-acquisition blood flow calculations, using our previously published technique (Wang et al., 2009).

Results: The average blood flow in pentoxifylline-treated eyes with NAION was 29 µl/min, which was comparable to 28 μL/min in the previous untreated cohort of NAION eyes (Wang et al.; IOVS 52(2): 840, 2011). The average blood flow in the fellow eye of treated patients with unilateral NAION was 52 µl/min, which was a small increase from somewhat younger control eyes in the previous cohort (45 μL/min; Wang et al., 2009).

Conclusions: Doppler OCT may be promising as a technique for comparing treated to untreated eyes. When compared to untreated normative data, pentoxifylline was associated with a small increase in the retinal blood flow of fellow eyes in patients with unilateral NAION. Pentoxyfylline did not increase blood flow in affected eyes. Further data collection is ongoing to permit a statistical analysis.

Keywords: 552 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • 572 ischemia • 613 neuro-ophthalmology: optic nerve