HEMODILUTION THERAPY IN CENTRAL RETINAL VEIN OCCLUSION - ONE-YEAR RESULTS OF A PROSPECTIVE RANDOMIZED STUDY

Systemic hemorheologic abnormalities may play a part in the pathogenes is of central retinal vein occlusions. A statistically significant ele vation of plasma viscosity was found in patients with acute central re tinal vein occlusion compared with control patients. Local retinal blo od flow parameters including arteriovenous passage time and mean arter ial dye bolus velocity were significantly altered in the central retin al vein occlusion patients compared with age-matched controls at basel ine examination. We performed a randomized, prospective, single-blind clinical investigation to determine the effect of hemorheological mani pulation on the clinical course and retinal blood flow of eyes with ce ntral vein occlusion. Hemodilution included plasma expansion with hydr oxyethyl-starch, withdrawal of whole blood if the hematocrit was above 42%, and rheologic manipulation with parenteral pentoxifylline. We fo und a statistically significant improvement in visual acuity at 1 year post-treatment for the treated group compared with the control group (increase of visual acuity of 1.5 lines vs decrease of 1.5 lines). The retinal blood flow parameters were markedly improved soon after the i nstitution of therapy, and this may have contributed to the improvemen t in visual acuity in the treated group. There was no statistically si gnificant difference between the two groups in the progression to isch emic central vein occlusion.