Ocular and optic nerve ischemia: recognition and treatment with intravenous prostaglandin E1.

Ischemia of the optic nerve, the retina and the choroid are common problems in ophthalmology. This paper presents the different types of ischemia and their treatment with prostaglandin E1 (PGE1), a powerful vasodilator of the microcirculation. This is a review article of various previously published case reports and studies presenting patients with different types of ocular and optic nerve ischemia. Their treatment with intravenous (IV) PGE1 is described. Treatment for acute and chronic problems is presented. The visual acuity and/or the visual fields improved in almost all the treated patients. When measured, the blood flow velocities also improved. No complications due to the use of PGE1 were seen. Treatment with IV PGE1 should be considered in cases of ocular and optic nerve ischemia to immediately restore blood flow to these structures and improve the visual acuity. Intravenous prostaglandin E1 is an effective treatment for ocular and optic nerve ischemia leading to immediate visual improvement.