Paper Information

Journal:   JOURNAL OF CURRENT OPHTHALMOLOGY   2004 , Volume 17 , Number 2; Page(s) 13 To 18.
 
Paper: 

DEXTROMETHORPHAN, A NEW TREATMENT FOR PATIENTS WITH CENTRAL RETINAL ARTERY OCCLUSION

 
 
Author(s):  MIRMOHAMMAD SADEGHI A., TABATABAEI S.A.*, RIAZI ESFAHANI M., AMOUZADEH J.
 
* Farabi Hospital, Tehran University of Medical Sciences
 
Abstract: 

Purpose: Many studies showed that glutamate has an important role in retinal ischemic injury. Dextromethorphan is an antagonist of glutamate receptors and may prevent ischemic injury in retina. Six studies on rabbits showed the effectiveness of this drug in decreasing retinal injury in central retinal artery occlusion. This study evaluates effect of dextromethorphan on improving LogMAR of patients with central retinal artery occlusion.
Methods: All patients with central retinal artery occlusion (except those with cilioretinal sparing) were treated with routine treatments. One group of them was given oral dextromethorphan (30 mg qid for 3 weeks with tapering over 1 week). Difference of LogMARs between first and last visits (3 months after the first visit) was calculated for each patient. Mean of these differences was compared in 2 groups.
Results: We followed 30 patients with central retinal artery occlusion. 15 patients were given dextromethorphan. The mean age of all patients was 56.33 years. Only 2 patients in no-dextromethorphan group had NVI. Mean difference of LogMARs in no-dextro group was 0.6 (SD=0.6) and in dextro group was 1.21 (SD=0.8). Difference of means was significant (P=0.01). This difference was significant among patients without systemic disease (P=0.005) and patients coming after 12 hours (P=0.005, 0.03) but was not significant among patients with systemic disease (P=0.2) and patients coming before 12 hours (P=0.9).
Conclusion: Dextromethorphan can be effective in improving visual prognosis in central retinal artery occlusion. Loss of effectiveness of this drug in patients with systemic disease may be due to associated retinal lesions or severe ischemia. Loss of effectiveness in patients coming before 12 hours may be due to less neuronal injury and better visual prognosis.

 
Keyword(s): DEXTROMETHORPHAN, CENTRAL RETINAL ARTERY OCCLUSION, NMDA ANTAGONISTS
 
References: 
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