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.

Abstract

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. 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. 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. 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.