Korean J Ophthalmol.  2017 Apr;31(2):123-131. 10.3341/kjo.2017.31.2.123.

Oral Administration of Cilostazol Increases Ocular Blood Flow in Patients with Diabetic Retinopathy

• Hwang DJ
• Shin JY
• Yu HG

• KMID: 2373468
• DOI: http://doi.org/10.3341/kjo.2017.31.2.123

Abstract

PURPOSE
To investigate the effect of cilostazol on ocular hemodynamics and to determine whether the administration of cilostazol increases the ocular blood flow in patients with diabetic retinopathy.
METHODS
This prospective observational study investigated the effect of orally administered cilostazol on diabetic retinopathy. Before and after administration for 1 week, pulsatile ocular blood flow (POBF) and retrobulbar hemodynamics were measured using a POBF analyzer and transcranial Doppler imaging, respectively. Visual acuity, intraocular pressure, and blood pressure were also evaluated before and after treatment.
RESULTS
Twenty-five eyes of 25 patients were included in this study. POBF increased significantly (16.8 ± 4.6 µL/sec vs. 19.6 ± 6.2 µL/sec, p < 0.001) after administration of cilostazol, while no significant change was identified in visual acuity, intraocular pressure, and blood pressure. Mean flow velocity in the ophthalmic artery as measured with transcranial Doppler imaging also increased significantly after medication (23.5 ± 5.6 cm/sec vs. 26.0 ± 6.9 cm/sec, p = 0.001). The change in POBF directly correlated with the change in mean flow velocity (r = 0.419, p = 0.007).
CONCLUSIONS
Cilostazol was effective in increasing ocular blood flow in patients with diabetic retinopathy, possibly by modulating retrobulbar circulation.

Keyword

Blood flow velocity; Cilostazol; Diabetic retinopathy; Pulsatile flow

MeSH Terms

Administration, Oral*
Blood Flow Velocity
Blood Pressure
Diabetic Retinopathy*
Hemodynamics
Humans
Intraocular Pressure
Observational Study
Ophthalmic Artery
Prospective Studies
Pulsatile Flow
Visual Acuity

Figure

• 

  Fig. 1 (A) The pulsatile ocular blood flow analyzer (Paradigm Medical Instruments, Salt Lake City, UT, USA), (B) the transcranial Doppler image using a TCD150M device (Spencer Technologies, Seattle, WA, USA). This case shows a peak systolic velocity (PEAK), mean flow velocity (MEAN), end diastolic velocity (DIAS) and pulsatility index (PI) of the left ophthalmic artery at 1 week after the administration of cilostazol.

• 

  Fig. 2 One week after cilostazol administration, (A) pulsatile ocular blood flow (POBF) had increased by 17.1% (p < 0.001) and (B) mean flow velocity (MFV) of ophthalmic artery (OA) had increased by 11.7% (p = 0.001). Values are means with error bars representing standard deviation.

• 

  Fig. 3 Spearman's regression analysis showed that the change in pulsatile ocular blood flow (POBF) was found to correlate with the change in mean flow velocity (MFV) of the ophthalmic artery: (A) absolute change: r = 0.404, p = 0.010; (B) percentage change: r = 0.419, p = 0.007.

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