AUTHOR=Jin Xin , Fu Junxia , Lv Ruju , Hao Xiaolu , Wang Song , Sun Mingming , Xu Guangcan , Zhang Qi , Zhang Lei , Li Yan , Xu Quangang , Hou Baoke 

TITLE=Efficacy and safety of platelet-rich plasma for acute nonarteritic anterior ischemic optic neuropathy: a prospective cohort study

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1344107

DOI=10.3389/fmed.2024.1344107

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Background</title><p>As the most common acute optic neuropathy in older patients, nonarteritic anterior ischemic optic neuropathy (NAION) presents with varying degrees of visual acuity loss and visual field defect. However, there is no generally accepted treatment for NAION.</p></sec><sec id="sec2"><title>Objectives</title><p>To evaluate the efficacy and safety of platelet-rich plasma (PRP) for patients with acute NAION within 2 months.</p></sec><sec id="sec3"><title>Design</title><p>A prospective, nonrandomized controlled trial.</p></sec><sec id="sec4"><title>Methods</title><p>Twenty-five eyes of 25 patients were enrolled. Of them, 13 received anisodine hydrobromide and butylphthalide-sodium chloride injection continuously for 10 days as basic treatment in the control group, and 12 received two tenon capsule injections of PRP on a 10 days interval as an additional treatment in the PRP group. We compared the best-corrected visual acuity (BCVA) and capillary perfusion density (CPD) of radial peripapillary capillaries and the moth-eaten eara of the peripapillary superficial capillary plexus and deep capillary plexus at 1 day (D1) before the first PRP treatment and 7 days (D7), 14 days (D14), and 30 days (D30) after the first PRP injection. Ocular and systemic adverse effects were assessed.</p></sec><sec id="sec5"><title>Results</title><p>In the PRP group, a better BCVA occurred at D30 (adjusted <italic>p</italic> = 0.005, compared with D1, recovered from 0.67 ± 0.59 to 0.43 ± 0.59), and a significant improvement in CPD was observed at D30 (adjusted <italic>p</italic> &lt; 0.001, <italic>p</italic> = 0.027, <italic>p</italic> = 0.027, compared with D1, D7, D14, in sequence, the value was 35.97 ± 4.65, 38.73 ± 4.61, 39.05 ± 5.26, 42.71 ± 4.72, respectively). CPD at D7 in the PRP group was better than that in the control group (<italic>p</italic> = 0.043). However, neither BCVA nor the moth-eaten area index were significantly different (all <italic>p</italic> &gt; 0.5) between the two groups. The main adverse effect was local discomfort resolved within 1 week, and no other systemic adverse events occurred.</p></sec><sec id="sec6"><title>Conclusion</title><p>Tenon capsule injection of PRP was a safe treatment for AION and could improve capillary perfusion of the optic nerve head and might be helpful in increasing short-term vision in patients with acute NAION.</p></sec>