Comparison of hyperbaric oxygen versus iloprost treatment in an experimental rat central retinal artery occlusion model

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 254; no. 11; pp. 2209 - 2215
• Main Authors: Karaman, Suleyman, Ozkan, Berna, Yazir, Yusufhan, Yardimoglu, Melda, Gok, Mustafa, Kara, Ozgur, Vural, Cigdem, Rencber, Selenay, Emek, Salih K.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2016; Springer Nature B.V
• Subjects: Animals; Apoptosis; Basic Science; Disease Models, Animal; Hyperbaric Oxygenation - methods; Iloprost - administration & dosage; In Situ Nick-End Labeling; Injections, Intraperitoneal; Male; Medicine; Medicine & Public Health; Ophthalmology; Rats; Rats, Wistar; Retinal Artery Occlusion - diagnosis; Retinal Artery Occlusion - therapy; Retinal Ganglion Cells - pathology; Treatment Outcome; Vasodilator Agents - therapeutic use; Hyperbaric oxygen therapy; Retinal artery occlusion; İloprost; İschemia-reperfusion injury
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-016-3444-5

Purpose Central retinal artery occlusion (CRAO) is one of the serious ophthalmological emergencies with poor visual prognosis. Iloprost is a stable prostacyclin analogue and has prominent anti-edema, anti-inflammatory, vasodilatory, and antiagregant effects. The main objective of this work was to investigate iloprost as an alternative agent versus hyperbaric oxygen (HBO) in the treatment of CRAO. Methods Twenty-eight healthy Wistar albino male rats were randomly assigned into control ( n  = 7, sham operation), HBO ( n  = 7), iloprost ( n  = 7), and sham groups ( n  = 7). CRAO model was created through optic nerve exploration and ligation. Full-thickness retina (FTR), outer nuclear layer (ONL), inner nuclear layer (INL) and ganglion cell layer (GCL) thickness were measured on Hematoxylin/Eosin (H&E) stained retinal sections and immunohistochemical analysis including terminal deoxynucleotidyl transferase-mediated biotindeoxyuridine triphosphate nick-end labeling (TUNEL) assay was performed to determine the apoptotic index (AI). Results AI values of HBO (0.204 ± 0.067) and iloprost (0.197 ± 0.052) groups were significantly lower than sham (0.487 ± 0.046) group ( p  < 0.001). Any significant difference was found between the HBO and iloprost groups in terms of AI ( p  = 0.514). A statistically significant increase in thickness of FTR, ONL, INL and GCL was detected in HBO, iloprost and sham groups compared to the control group ( p  = 0.002). FTR, ONL, INL and GCL thickness were significantly thinner in HBO and iloprost groups than in the sham group ( p  = 0.002). A significant lesser increase was observed in all the retinal layers thickness in iloprost group versus HBO group ( p  = 0.002) except for INL ( p  = 0.665). Conclusions The study results demonstrated anti-edema, neuroprotective, and anti-apoptotic effects of iloprost quantitatively; thus, iloprost may be a beneficial alternative agent in the treatment of CRAO.