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.
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.
Authors: Randy W Braith; C Richard Conti; Wilmer W Nichols; Calvin Y Choi; Matheen A Khuddus; Darren T Beck; Darren P Casey Journal: Circulation Date: 2010-10-04 Impact factor: 29.690
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