Int J Angiol 2010; 19(3): e113-e115
DOI: 10.1055/s-0031-1278380
Case Report

© Georg Thieme Verlag KG Stuttgart · New York

Arteritic anterior ischemic optic neuropathy treated with intravenous prostaglandin E1 and steroids

Robert D Steigerwalt1 , M Rosaria Cesarone2 , Gianni Belcaro2 , Antonella Pascarella3 , Mauro De Angelis3 , Roberto Gattegna4 , Marcella Nebbioso5
  • 1Via A Brofferio, Rome, Italy
  • 2Irvine Vascular Research Center, San Valentino, Pescara, Rome, Italy
  • 3Ophthalmic Hospital, Medical Retina, Rome, Italy
  • 4Via Grazioli Lante, Rome, Italy
  • 5Department of Ophthalmology, University of Rome “La Sapienza”, Rome, Italy
Further Information

Publication History

Publication Date:
28 April 2011 (online)


Arteritic anterior ischemic optic neuropathy (AAION) is an acute ischemia of the posterior ciliary arteries and/or ophthalmic artery due to inflammation. Therapy is immediate intervention with systemic steroids, especially to protect against vision loss in the other eye. The addition of a potent vasodilator to the steroids could help restore ocular blood flow and improve visual acuity. The objective of the current report was to present the use of prostaglandin E1 (PGE1) - a powerful vasodilator of the microcirculation - in the treatment of AAION. Two patients with AAION were treated with intravenous steroids and PGE1. The visual acuity improved from 4/50 (less than 20/200) to 6/10 (20/35) in one patient and from 1/50 (20/400) to 1/10 (20/200) in the second patient. The visual fields in both patients maintained small central islands of vision. No complications due to the use of PGE1 were seen. Intravenous PGE1 should be considered in addition to steroids in cases of AAION to immediately restore blood flow to the optic nerve and improve visual acuity while the steroids reduce the inflammation.