Intravitreal injection of granulocyte-colony stimulating factor (G-CSF) for the treatment of non-arteritic anterior ischemic optic neuropathy: a pilot study

Kaveh Abri Aghdam1 *, Ali Aghajani1 , Maryam Ashraf Khorasani1 , Mostafa Soltan Sanjari1 , Abbas Habibi1 , Khalil Ghasemi Falavarjani1

  1. Department of Ophthalmology, Eye Research Center, The Five Senses Institute, Rassoul Akram hospital, Iran University of Medical Sciences, Tehran, Iran

Abstract: To investigate the feasibility and efficacy of intravitreal injection of granulocyte colony-stimulating factor (G-CSF) for the treatment of non-arteritic anterior ischemic optic neuropathy (NAION).

Methods: In this prospective interventional case series, patients with acute NAION were enrolled. They received an intravitreal injection of 60 micrograms in 0.1 ml of G-CSF within 2 weeks of the onset of the disease. Visual acuity, visual field, intraocular pressure (IOP), corneal endothelial cell density, and peripapillary retinal nerve fiber layer (RNFL) thickness were recorded before injections and 1 week, 1 month, 3 months, 6 months, and one year after the injections. Full-field electroretinography (ERG) was obtained at baseline, 1 month, and 12 months after the injections.

Results: Fourteen eyes of 14 patients entered the study. Best-corrected visual acuity (BCVA) significantly improved in the first month following injections (p=0.007), decreased subsequently and the final BCVA had no significant improvement (p=0.278) compared to the baseline measurements. A significant decrease in RNFL thickness was observed in all quadrants compared to the baseline measurements. No improvement in the visual field parameters was also observed. From the toxicity aspect, no significant changes in the corneal endothelial cell density, IOP, and ERG recordings were observed.

Conclusion: Intravitreal injection of G-CSF seems to be safe. The effect may last for one month and then decline.





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