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Effect of enhanced extracorporeal counterpulsation in patients with non-arteritic anterior ischaemic optic neuropathy

  • Neurophthalmology
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

The purpose is to study the effect of Enhanced Extracorporeal Counterpulsation (EECP) in patients with non-arteritic anterior ischaemic optic neuropathy (NAION).

Methods

EECP is a noninvasive, mechanical, and circulatory support therapy. Sixteen patients with unilateral NAION were treated with EECP (twelve 1-h daily treatment sessions for each patient). Color Doppler imaging (CDI) was applied to measure the mean flow velocity (MFV), peak-systolic velocity (PSV), end-diastolic velocity (EDV) of the ophthalmic artery (OA) and central retinal artery (CRA). Intraocular pressure (IOP) was measured by Goldmann applanation tonometry. Measurements were collected before and immediately after the first and the last sessions of EECP in both eyes, and they were compared with the baseline measurement before EECP. The measurements were also compared between the NAION eyes and the normal fellow eyes. Visual acuity (VA) and visual field (VF) were assessed before EECP and after the last EECP.

Results

EECP progressively increased blood flow velocities of the OA and CRA and progressively decreased IOP in both eyes (P < 0.05). After the first session of EECP, there was a 16 ± 5.3 % increase in EDV and a 13.9 ± 9.5 % increase in MFV of the OA, and a 17.1 ± 2.5 % increase in PSV, a 21.2 ± 9.3 % increase, in EDV and a 16.5 ± 3.3 % increase in MFV of the CRA in NAION eyes. After the last EECP treatment, there was a 16.8 ± 6.7 % increase in EDV and a 14.0 ± 5.1 % increase in MFV of the OA, and a 17.7 ± 12.3 % increase in PSV, a 23.1 ± 6.3 % increase in DSV, and a 21.1 ± 8.4 % increase in MFV of the CRA in NAION eyes (P < 0.05). The change of the PSV, EDV, and MFV in the CRA were more significant in NAION eyes than that of their fellow eyes (P < 0.05). VA was improved and VF mean deviation was decreased in NAION eyes after the last EECP treatment (P = 0.003 and 0.049, respectively), and VA improvement was correlated positively with the blood flow parameter.

Conclusions

EECP could be a clinically effective and safe treatment for NAION.

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Acknowledgments/disclosure

All authors have completed and submitted the ICMJE form for disclosure of potential conflicts of interest, and no conflicts were reported. Funding support was provided from the Medical Research Foundation of Guangdong, China (grant B2011081).

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Authors and Affiliations

  1. Department of Ophthalmology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China

    Wenhui Zhu, Ruiduan Liao & Yongchong Chen

  2. Department of Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China

    Li Liu

  3. Department of Cardiovascular Medicine, The Key Laboratory on Assisted Circulation, Ministry of Health, The First Affiliated Hospital of Sun Yat-sen University, #58 Zhongshan Second Road, Guangzhou, 510080, China

    Yan Zhang

Authors
  1. Wenhui Zhu
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  2. Ruiduan Liao
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  3. Yongchong Chen
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  4. Li Liu
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  5. Yan Zhang
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Correspondence to Yan Zhang.

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Zhu, W., Liao, R., Chen, Y. et al. Effect of enhanced extracorporeal counterpulsation in patients with non-arteritic anterior ischaemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 253, 127–133 (2015). https://doi.org/10.1007/s00417-014-2823-z

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  • DOI: https://doi.org/10.1007/s00417-014-2823-z

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