[Hemodilution therapy in patients with acute anterior ischemic optic neuropathy]

A prospective study was performed in 22 patients with an anterior ischaemic optic neuropathy (AION). All patients underwent iso- (Hct > or = 42%) or hypervolemic (Hct < 42%) haemodilution for 10 days with daily infusion of 250 ml hydroxyethyl starch (MW 200,000/0.5, 10% HAES-sterile) in combination with pentoxifylline (p.o.: 1200 mg/day; i.v.: 300 mg/day; Trental). Only patients with recent AION (less than 2 weeks' duration of symptoms) were considered for the prospective trial. Clinical, haemodynamic (arterio-venous passage time) and rheological (haematocrit, plasma viscosity, erythrocyte aggregation) data of all patients were recorded before therapy and after 10 days. An improvement of central vision by 2 or more lines was seen in 7 patients after 10 days. Initially the arterio-venous passage time was significantly prolonged in patients (2.42 +/- 0.7 s) with AION compared with healthy volunteers (1.45 +/- 0.4 s). After the 10-day trial arterio-venous passage time was significantly shorter than baseline values. In addition, the initially elevated plasma viscosity (1.33 +/- 0.1 mPa) was significantly lowered by haemodilution therapy.