Background: Cilostazol, a selective type III phosphodiesterase inhibitor, has antiplatelet and vasodilating effects and has been proposed to have beneficial effects on prevention of atherosclerosis. We investigated the effects of cilostazol in the progression of carotid intima-media thickening (IMT) and total plaque area (TPA) in patients with vascular retinopathy.
Methods: From December 2009 to April 2010, a total of 63 consecutive vascular retinopathy patients with carotid atherosclerosis who are naïve in cilostazol were enrolled. We examined the changes of carotid IMT/TPA and visual acuity/macular thickness before and after 1-year treatment of cilostazol (200 mg/d).
Results: Plasma hs-CRP, the total cholesterol level and microalbuminuria was significantly reduced (p<0.05) and high density lipoprotein cholesterol (HDL-C) was increased (P<0.003) after cilostazol treatment. Mean left, mean right common carotid artery and mean left, mean right internal carotid artery IMT was significantly reduced after cilostazol treatment compared with baseline (0.80±0.16 vs. 0.89±0.17 mm, P=0.002; 0.77±0.15 vs.0.88±0.21 mm, P=0.001; 0.66±0.16 vs.0.72±0.16 mm, P=0.020; and 0.64±0.11 vs.0.75±0.27 mm, P=0.004). Although there was no significant difference in TPA before and after treatment (0.61±0.94 vs. 0.45±0.79 cm2, P=0.291), however, significant regression (0.14±0.15 vs. 0.25±0.14 cm2, P=0.004) was observed in patients with TPA <0.5 cm2(n=30). Cilostazol treatment resulted in significant improvement in visual acuity (0.56±0.79 vs. 0.35±0.25, P=0.002) and reduction in macular thickness (257.43±112.09 vs. 394.16±171.83 m, P<0.001) compared with baseline.
Conclusions: Cilostazol potently inhibited progression of carotid IMT, and may have a role in regression of carotid atheroma burden in vascular retinopathy patients. Cilostazol showed favorable effects on vascular retinopathy, as well, but the mechanism of opthalomologic effect is currently unknown.
Key Words: cilostazol , atherosclerosis, carotid arteries , retinopathy
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