Abstract
Purpose::
To evaluate the neural conduction along the visual pathways after oral treatment with Cytidine-5’-diphosphocholine (Citicoline) in patients with optic nerve diseases.
Methods::
30 patients with open-angle glaucoma (OAG, mean age 45.6±4.3ys) and 15 patients (mean age 64.6±3.3ys) with non-arteritic ischemic optic neuropathy (NION) were enrolled. Ten OAG patients were untreated (NT-AOG, 10 eyes), while 20 OAG patients (T-AOG, 20 eyes) and 15 NION patients (T-NION, 14 eyes) had oral treatment with Citicoline (1600 mg/die per 60 days) (Cebrolux®, Tubilux, Italy). In T-OAG and T-NION patients, Visual Evoked Potentials (VEPs) were assessed 5 times during a total period of 360 days: at baseline conditions (0 day), after two different cycles of 60 days of treatment (days 0-60 and days 180-240), and after two different cycles of 120 days of wash out (days 60-180 and 240-360). In NT-AOG patients, VEPs were assessed at baseline conditions (0 day) and after 60, 180, 240 and 360 days.
Results::
Similar values of VEP parameters (ANOVA, P>0.05) were observed in NT-OAG and T-OAG patients at baseline conditions. Unmodified (P>0.05) VEP responses were observed in NT-OAG patients after 60, 180, 240 and 360 days with respect to baseline conditions. A shortening in VEP P100 latencies and an increase in VEP N75-P100 amplitudes (P<0.01) were found in T-OAG and T-NION patients after two 60 day-long cycles of treatment (days 60 and 240) with respect to the values previously observed at 0 and 180 days. A delay in VEP latencies and a decrease in VEP amplitudes were found in T-OAG and T-NION patients, after two 120 day-long cycles of wash out (days 180 and 360) with respect to the values observed at 60 and 240 days. Nevertheless, VEP latencies and amplitudes observed in both T-OAG and T-NION patients at 180 and 360 days were still respectively shorter and greater than baseline values (P<0.01)
Conclusions::
Our results suggest that Citicoline therapy induces an improvement in neural conduction along the visual pathways in patients affected by optic nerve diseases. As observed after intramuscular treatment with Citicoline,1 the beneficial effect is treatment-dependent. Nevertheless, the pharmacological effect is in part maintained 120 days after the end of treatment.1Parisi et al., Ophthalmology 1999;106:1126-34; Parisi V. Doc Ophthalmol. 2005;110:91-102
Clinical Trial::
www.clinicaltrials.gov NCT00404729
Keywords: neuro-ophthalmology: cortical function/rehabilitation • electrophysiology: clinical • visual impairment: neuro-ophthalmological disease