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Does topical brimonidine tartrate help NAION?
  1. H E Fazzone1,
  2. M J Kupersmith1,
  3. J Leibmann2
  1. 1The Institute for Neurology and Neurosurgery, Beth Israel Medical Center, the New York Eye and Ear Infirmary New York, USA
  2. 2The New York Eye and Ear Infirmary
  1. Correspondence to: Mark J Kupersmith, MD, Department of Neuro-ophthalmology, Room 535, The Institute for Neurology and Neurosurgery, Beth Israel Medical Center, 170 East End Avenue, New York, NY 10128, USA; mkuper{at}bethisraelny.org

https://doi.org/10.1136/bjo.87.9.1193

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    There is no proved treatment for non-arteritic anterior ischaemic optic neuropathy (NAION). Topical brimonidine tartrate has been reported to have a neuroprotective benefit for retinal ganglion cells following experimental elevation of intraocular pressure and optic nerve injury in the rat, which is blocked with coadministration of the α-2 antagonist, rauwalscine.1–3 Increased retinal ganglion cell survival has also been shown to occur following oral administration of brimonidine in monkeys with experimental glaucoma.4 These results were the basis of the recently aborted clinical trial of topical brimonidine purite for acute NAION and our retrospective study of 31 patients with NAION, who were evaluated within 3 weeks of the onset of visual loss and had follow up for a minimum of 8 weeks. During 2001–2, we treated all (14) patients with brimonidine tartrate within 14 days (mean 5.5, SD 5.52) of the onset of visual loss. Five patients were treated after 1 day of symptoms. The drops were taken four times a day in 11, three times a day in one, and twice a day in two patients. All (17) untreated patients were evaluated the year before and were matched to the treated group for age, sex, cardiovascular risk factors, previous aspirin use, and previous first eye NAION.

    Snellen visual acuity and colour vision, using the Ishihara colour plates, were …

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