Cytidine-5′-diphosphocholine (citicoline) improves retinal and cortical responses in patients with glaucoma
Cytidine-5′-diphosphocholine (citicoline) improves retinal and cortical responses in patients with glaucoma
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DOI：
10.1016/s0161-6420(99)90269-5
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发表时间：
1999-06-01
期刊：
影响因子：
13.7
通讯作者：
Bucci, MG
中科院分区：
文献类型：
--
作者：
Parisi, V;Manni, G;Bucci, MG
目的：评价胞苷二磷酸胆碱的作用目的：观察胞磷胆碱对青光眼患者视网膜功能和皮质反应的影响。方法：随机临床试验。对象：40例开角型青光眼患者随机分为两组：胞磷胆碱组（n = 40），对照组（n = 40），观察胞磷胆碱对青光眼患者视网膜功能和皮质反应的影响。（[GC] n = 25）和安慰剂组方法：采用神经罗通治疗胃癌患者15例GP患者用安慰剂（含添加剂的生理溶液）治疗60天。在120天的洗脱期（第180天）后，GC患者被分为两个年龄匹配的组：10名患者（GC 1组）的洗脱期延长了120天; 15名患者（GC 2组）的第二个60天的胞磷胆碱治疗期后，第二个120天的洗脱期。在第180天，GP患者的洗脱期再延长180天。在所有受试者中，通过同时记录基线、60天和180天后的视觉诱发电位（VEP）和图形视网膜电图（PERG）来评估视网膜和皮质反应。在第300天，对GC 1组患者、GC 2组和GP组患者分别在第240天和第360天进行VEP和PERG检测。主要观察指标：视觉诱发电位参数（P100潜伏期和N75-P100振幅）; PERG参数（P50潜伏期和P50-N95振幅）和眼内压。GP患者在所有检查中显示相似的VEP和PERG参数。GC患者经胞二磷胆碱治疗后VEP和PERG参数明显改善（P < 0.01），与GP患者比较差异有显著性（P <0.01）。GC患者在洗脱后记录的视觉诱发电位和PERG显示，虽然有恶化的趋势，但电生理改善仍然保持。第二个洗脱期后，GC 1组VEP和PERG参数与基线值和GP组相似（P > 0.05）。GC 2组第2疗程胞磷胆碱治疗后VEP和PERG参数进一步改善（P < 0.01）。结论：胞磷胆碱可改善青光眼患者的视网膜和视路功能。
Purpose: To evaluate the effects of cytidine-5'-diphosphocholine (citicoline) on retinal function and on cortical responses in patients with glaucoma.Design: Randomized clinical trial.Participants: Forty patients with open-angle glaucoma were randomly divided into two age-matched groups: citicoline group ([GC] n = 25) and placebo group ([GP] n = 15).Methods: The GC patients were treated with Neuroton (citicoline, 1000 mg/day intramuscularly) for 60 days; GP patients were treated with placebo (physiologic solution with additives) for 60 days. After 120 days of washout (day 180), the GC patients were divided into two age-matched groups: in 10 patients (GC1 group) the washout was prolonged for a further 120 days; in 15 patients (GC2 group) a second 60-day period of citicoline treatment was followed by a second 120-day period of washout. At day 180, the washout was extended for another 180 days in GP patients. In all subjects, retinal and cortical responses were evaluated by simultaneous recordings of visual evoked potentials (VEPs) and pattern-electroretinograms (PERGs) at baseline, after 60 days, and after 180 days. At day 300, VEPs and PERGs were also evaluated in GC1 patients, and at 240 and 360 days in GC2 and GP patients.Main Outcome Measures: Visual evoked potential parameters (P100 latency and N75-P100 amplitude); PERG parameters (P50 latency and P50-N95 amplitude); and intraocular pressure.Results: The GP patients displayed similar VEP and PERG parameters in all examinations performed. In GC patients, the treatment with citicoline induced a significant (P < 0.01) improvement of VEP and PERG parameters, and their values were significantly different (P < 0.01) with respect to those of GP patients (P < 0.01). Visual evoked potentials and PERGs, recorded in GC patients after washout, revealed that although there was a worsening trend, the electrophysiologic improvement was still maintained. After a second period of washout, GC1 patients had VEP and PERG parameters similar (P > 0.05) to baseline ones and to those of GP patients. In GC2 patients, a second period of citicoline treatment induced a further (P < 0.01) improvement of VEP and PERG parametersConclusion: Citicoline may induce an improvement of the retinal and of the visual pathway function in patients with glaucoma.