Acute branch retinal arterial embolism successfully treated with intravenous prostaglandin E1--case reports

The purpose of this paper is to report the use of intravenous prostaglandin E1, a potent vasodilator, to rapidly restore blood flow and vision in a patient with an acute branch retinal arterial occlusion. An 82-year-old woman with an acute decrease in the visual acuity of her left eye due to an acute superior temporal branch retinal arterial embolus was treated with 140 microg of intravenous prostaglandin E1. The medicine was repeated the following day. At the onset of the branch arterial occlusion her vision in the left eye was 20/50, the embolus could be seen in the superior temporal branch, and a white retinal edema extended down into the macula. At her first eye examination 4 days after treatment, her visual acuity had returned to 20/20, the retinal embolus was still present, but the white macular edema had disappeared. Intravenous prostaglandin E1 is a safe, potent vasodilator for the peripheral vascular system. If used immediately to treat acute branch arterial retinal occlusions, it can restore good vision. The authors report the first case of the use of intravenous prostaglandin E1 to treat a spontaneous acute branch retinal arterial embolus.