Parisi V, Manni G, Colacino G, Bucci M G
Cattedra di Clinica Oculistica, Universita' di Roma Tor Vergata, Rome, Italy.
Ophthalmology. 1999 Jun;106(6):1126-34. doi: 10.1016/S0161-6420(99)90269-5.
To evaluate the effects of cytidine-5'-diphosphocholine (citicoline) on retinal function and on cortical responses in patients with glaucoma.
Randomized clinical trial.
Forty patients with open-angle glaucoma were randomly divided into two age-matched groups: citicoline group ([GC] n = 25) and placebo group ([GP] n = 15).
The GC patients were treated with Neuroton (citicoline, 1000 mg/day intramuscularly) for 60 days; GP patients were treated with placebo (physiologic solution with additives) for 60 days. After 120 days of washout (day 180), the GC patients were divided into two age-matched groups: in 10 patients (GC1 group) the washout was prolonged for a further 120 days; in 15 patients (GC2 group) a second 60-day period of citicoline treatment was followed by a second 120-day period of washout. At day 180, the washout was extended for another 180 days in GP patients. In all subjects, retinal and cortical responses were evaluated by simultaneous recordings of visual evoked potentials (VEPs) and pattern-electroretinograms (PERGs) at baseline, after 60 days, and after 180 days. At day 300, VEPs and PERGs were also evaluated in GC1 patients, and at 240 and 360 days in GC2 and GP patients.
Visual evoked potential parameters (P100 latency and N75-P100 amplitude); PERG parameters (P50 latency and P50-N95 amplitude); and intraocular pressure.
The GP patients displayed similar VEP and PERG parameters in all examinations performed. In GC patients, the treatment with citicoline induced a significant (P < 0.01) improvement of VEP and PERG parameters, and their values were significantly different (P < 0.01) with respect to those of GP patients (P < 0.01). Visual evoked potentials and PERGs, recorded in GC patients after washout, revealed that although there was a worsening trend, the electrophysiologic improvement was still maintained. After a second period of washout, GC1 patients had VEP and PERG parameters similar (P > 0.05) to baseline ones and to those of GP patients. In GC2 patients, a second period of citicoline treatment induced a further (P < 0.01) improvement of VEP and PERG parameters
Citicoline may induce an improvement of the retinal and of the visual pathway function in patients with glaucoma.
评估胞二磷胆碱对青光眼患者视网膜功能及皮质反应的影响。
随机临床试验。
40例开角型青光眼患者被随机分为两个年龄匹配组：胞二磷胆碱组（[GC]，n = 25）和安慰剂组（[GP]，n = 15）。
GC组患者接受神经妥乐平（胞二磷胆碱，1000 mg/天，肌肉注射）治疗60天；GP组患者接受安慰剂（含添加剂的生理溶液）治疗60天。洗脱120天（第180天）后，GC组患者被分为两个年龄匹配组：10例患者（GC1组）洗脱期再延长120天；15例患者（GC2组）在接受第二个60天的胞二磷胆碱治疗后再进行120天的洗脱期。在第180天，GP组患者的洗脱期再延长180天。在所有受试者中，在基线、60天后和180天后通过同步记录视觉诱发电位（VEP）和图形视网膜电图（PERG）来评估视网膜和皮质反应。在第300天，也对GC1组患者进行VEP和PERG评估，在第240天和360天对GC2组和GP组患者进行评估。
视觉诱发电位参数（P100潜伏期和N75 - P100波幅）；PERG参数（P50潜伏期和P50 - N95波幅）；以及眼压。
在所有进行的检查中，GP组患者的VEP和PERG参数相似。在GC组患者中，胞二磷胆碱治疗使VEP和PERG参数有显著（P < 0.01）改善，且其值与GP组患者相比有显著差异（P < 0.01）（P < 0.01）。GC组患者洗脱后记录的视觉诱发电位和PERG显示，尽管有恶化趋势，但电生理改善仍得以维持。在第二个洗脱期后，GC1组患者的VEP和PERG参数与基线及GP组患者相似（P > 0.05）。在GC2组患者中，第二个胞二磷胆碱治疗期使VEP和PERG参数进一步（P < 0.01）改善。
胞二磷胆碱可能使青光眼患者的视网膜及视觉通路功能得到改善。
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