epoetin-alfa and Optic-Neuropathy--Ischemic

Erythropoietin (EPO) is known as a hormone for erythropoiesis in response to anemia and hypoxia. However, the effect of EPO is not only limited to hematopoietic tissue. Several studies have highlighted the neuroprotective function of EPO in extra-hematopoietic tissues, especially the retina. EPO could interact with its heterodimer receptor (EPOR/βcR) to exert its anti-apoptosis, anti-inflammation and anti-oxidation effects in preventing retinal ganglion cells death through different intracellular signaling pathways. In this review, we summarized the available pre-clinical studies of EPO in treating glaucomatous optic neuropathy, optic neuritis, non-arteritic anterior ischemic optic neuropathy and traumatic optic neuropathy. In addition, we explore the future strategies of EPO for optic nerve protection and repair, including advances in EPO derivates, and EPO deliveries. These strategies will lead to a new chapter in the treatment of optic neuropathy.

Topics: Epoetin Alfa; Erythropoietin; Humans; Optic Nerve; Optic Nerve Diseases; Optic Nerve Injuries; Optic Neuropathy, Ischemic; Receptors, Erythropoietin

Preclinical data suggest that intravitreally administered erythropoietin (EPO) is both neuroprotective and safe. In a small pilot series, we intended to assess the feasibility of intravitreal EPO injections in humans.. Three patients with acute vascular occlusion of the posterior pole received a single intravitreal EPO injection of 2000 U. Immediately before the injection and over the ensuing 3 months, these patients were closely monitored by measuring visual acuity, visual fields, intraocular pressure, the electroretinogram, the haematocrit and serum EPO levels.. Over the observational period, most parameters remained unchanged except for a short-term rise of serum EPO levels, which, however, did not exceeded normal serum levels. No injection-related toxicity was observed.. Based on this limited set of data, a single EPO injection of 2000 U, a dose adapted from previous in vivo studies, is feasible and seems to induce no obvious damage. Hence, further investigations of this therapeutic approach appear justified.

Topics: Aged; Electroretinography; Epoetin Alfa; Erythropoietin; Feasibility Studies; Female; Humans; Injections, Intraocular; Intraocular Pressure; Male; Neuroprotective Agents; Optic Neuropathy, Ischemic; Pilot Projects; Recombinant Proteins; Retinal Artery Occlusion; Visual Acuity; Visual Fields; Vitreous Body