The Accumulative Effect of Intravenous Prostaglandin E1 Over 19 Years to Treat the Ocular Ischemia in High Myopia

Purpose: The purpose of this paper is to present the clinical history of the use of IV prostaglandin E1, a potent vasodilator of the peripheral vascular system, to treat ischemia in high myopia. This was originally reported in 2009. Methods: Three patients with high myopia and progressive visual loss were included. They all had documented ocular ischemia and were placed under treatment with IV prostaglandin E1 for the ischemia. Results: All three had central and peripheral visual improvement which initially lasted from 10 to 14 days after each treatment. Prostaglandin E1 was well tolerated by all three. One abandoned 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 19.5 years maintaining a good visual acuity allowing an independent life. He has been able to extend the intervals between treatments from 3.5 to 4 months. He had occasional hypotensive episodes when the medicine was increased especially during the summer. Conclusion: High myopia can be associated with severe central and peripheral visual loss. This can be due to ischemia and can lead to no light perception in severe cases if not treated. The author presents the use of IV prostaglandin E1 as a possible treatment which could be tried in these cases.