The Efficacy and Safety of Intravenous Prostaglandin E1 in the Management of Retinal Artery Occlusion: A Systematic Review.

Abstract

Purpose: To evaluate the efficacy and safety of prostaglandin E1 (PGE1) for the management of central/branch retinal artery occlusion (CRAO/BRAO).

Methods: Our protocol was registered prospectively on PROSPERO (CRD42024522961). We searched 4 electronic databases [PubMed, Scopus, Web of Science, and Google Scholar] to retrieve all studies reported using PGE1 for patients with CRAO/BRAO. We conducted a Wilcoxon signed-rank test to assess the effect of PGE1 on the visual acuity (VA) of included subjects. VA change was utilized as a measure to assess the degree of VA improvement. We assessed the quality of included studies using the JBI tool.

Results: We included a total of 6 studies with a total of 21 cases. Age ranged from 45 to 97 years with a mean of 65.76 years for 10 females and 11 males. Cases with CRAO represented 85.7% and BRAO represented 14.3% of total cases. The median time from symptoms onset to treatment initiation was 7 hours. The median for the initial dose was 40 μg. Wilcoxon signed-rank test revealed significant improvement in visual acuity after intravenous PGE1 treatment (V = 231, p < 0.05).

Conclusion: Our analysis revealed preliminary evidence suggesting that IV PGE1 may be a potentially safe and effective treatment for improving VA in patients with CRAO/BRAO. However, our evidence is limited as our review relies primarily on case reports and case series.