The Accumulative Effect of Intravenous Prostaglandin E1 over Nineteen Years to Treat the Ocular Ischemia in High Myopia Keywords: Ocular ischemia, high myopia, prostaglandin E1 (PGE1), extreme choroidal thinning Prostaglandin E1 in High Myopia

Retin Cases Brief Rep. 2024 Mar 27. doi: 10.1097/ICB.0000000000001577. Online ahead of print.

Abstract

Purpose: The purpose of this paper is to present the clinical history of the use of intrarvenous (IV) prostaglandin E1(PGE1), a potent vasodilator of the peripheral vascular system, to treat the ischemia in high myopia. This was originally reported in 2009.

Methods: Three patients with high myopia and progressive visual loss were seen. They all had documented ocular ischemia and were placed under treatment with IV PGE1 for the ischemia.

Results: All 3 had central and peripheral visual improvement which initially lasted from 10-14 days after each treatment. PGE1 was well tollerated by all 3. One abbandoned treatment after 4 months because she did not want to be part of an experiment. A second patient had irregular treatments which became ineffective after 15 years. The third has had regular treatments for the last 19 and 1/2 years maintaining a good visual acuity allowing an independent life. He has been able to extend the intervals between treatments to 3- 4 months. He had occasional hypotensive episodes when the medicine was increased especially during the summer.

Conclusion: High myopia can be associated with severe central and/or peripheral visual loss. This can be due to ischemia and can lead to NLP in severe cases if not treated. The author presents the use of IV PGE1 as a possible treatment which could be tried in these cases.