Effect of Oral Citicoline in Macular Ganglion Cell Layer (GCL) Thickness, After Epiretinal Membrane (ERM) Surgery with Internal Limiting Membrane (ILM) Peeling


SCIENTIFIC POSTER

Effect of Oral Citicoline in Macular Ganglion Cell Layer Thickness, After Epiretinal Membrane Surgery with Internal Limiting Membrane Peeling by Vania Lages


ABSTRACT

Introduction:

Beneficial effects of oral cytidine-5’-diphosphocholine (citicoline) have been described in neurologic and cognitive disorders, such as Parkinson’s disease, and in neuro-ophthalmic disorders, such as glaucoma and amblyopia. Previous studies reported a reduction in GCL thickness after ERM surgery with ILM peeling, with associated poor visual outcomes. The purpose of this study was to analyze the effect of citicoline treatment in macular GCL thickness, after ERM surgery with ILM peeling.

Methods:

Prospective, multicentric, controlled, observational study. 14 eyes (14 patients) with primary ERM were included and divided in two groups, the control group (CG) (n=5) and the study group (SG) (n=9). Both goups were submitted to a pars plana vitrectomy, with ILM peeling. The SG was supplemented with oral citicoline (500mg/day), starting 10 days before the surgery until one month after surgery. The main outcome measures were obtained before surgery and at one-month after surgery: best corrected visual acuity (BCVA), measured with decimal chart, central retinal thickness (CRT) and macular ganglion cell layer thickness (GCLT), measured with SD-OCT Spectralis®. Manual segmentation of GCL was done and the 4 macular subfields in a 3mm diameter circle, centered on the fovea, were used to take the measurements (superior, inferior, nasal and temporal sectors).

Results:

The CG included 5 eyes, with a mean age of 71,2 ± 4,4 years. The SG included 9 eyes, with a mean age of 69,0 ± 6,5 years. The mean preoperative BCVA was 0,25 ± 0,14 and 0,36 ± 0,12 in the CG and SG, respectively (p>0,05). The mean preoperative CRT was 378,17 ± 174,70 µm and 484,33 ± 95,36 µm in the CG and SG, respectively (p>0,05). The mean preoperative superior, inferior, nasal and temporal sectors of GCLT were 60,20 ± 3,87 , 62,00 ± 13,36, 58,20 ± 8,66 and 68,4 ± 14,05 µm in the CG and 58,89 ± 9,17 , 58,56 ± 9,38, 60,67 ± 7,10 and 57,67 ± 24,75 µm in the SG (p>0,05). The mean postoperative BVCA was 0,49 ±0,27 and 0,80 ± 0,10 in the CG and SG, respectively (p>0,05). The mean postoperative CRT was 407,00 ± 24,11 µm and 398,67 ± 47,93 µm in the CG and SG, respectively (p>0,05). The mean postoperative superior, inferior, nasal and temporal sectors of GCLT were 44,67 ± 20,16, 43,17 ± 19,49, 45,50 ± 21,08 and 41,17 ± 19,19 µm in the CG and 48,00 ± 8 ,06, 49,89 ± 10,03, 51,00 ± 9,73 and 51,67 ± 13,23 µm in the SG (p>0,05). Every patient in both groups improved visual acuity. The postoperative BCVA and the variation of the mean CRT and GLCT before and after surgery showed no statistically significant difference between both groups.

Conclusions:

In this study, citicoline admnistration did not influence visual and structural outcomes after pars plana vitrectomy, with EMR and ILM peeling. However, this is a preliminary study, with a small patient sample. In the future it is necessary to increase the sample size and follow up to evaluate if there is a neuroprotective effect of citicoline in these patients.


CONTACT DETAILS

 

Vania Lages
Porto, Portugal
Email : vania.mlages@gmail.com
Cell Phone: +351926717774
Work Phone: +351222077500