The influence of ticlopidine on the natural course of retinal vein occlusion.
A double-blind study was established to evaluate the platelet aggregation inhibiting effect of ticlopidine on the course of ocular vein occlusions. 35 patients with recent central retinal vein occlusions and 54 patients with retinal branch vein occlusions were treated for 6 months. Various ophthalmological and clinical-chemical parameters, including fluorescence angiography, were assessed. Compared with placebo therapy a significant improvement in visual acuity was observed with ticlopidine for branch vein occlusions; the same trend was seen for the central retinal vein occlusions. Increased ADP-induced platelet aggregation was frequently found: in 72% of the central retinal vein occlusions and 70% of the branch vein occlusions. For the Wu and Hoak test, these numbers were respectively 74% and 67%. Hypertension was seen in 55% of all occlusions, hyperlipaemia in 33%, and diabetes in 29%. The effect of ticlopidine was most pronounced in patients with increased platelet aggregation and least obvious in hyperlipaemia. Hypertension and diabetes did not apparently influence Ticlopidine's effects. It is concluded that the platelet aggregation inhibitor ticlopidine is effective in the treatment of recent ocular vein occlusions.