Impact of cilostazol on the progression of carotid atherosclerosis in patients with retinal vascular occlusion.

BACKGROUND: Cilostazol, a selective phosphodiesterase three inhibitor, has been proposed to have beneficial effects in the prevention of atherosclerosis.

AIMS: We aimed to investigate the effects of cilostazol on carotid intima-media thickening (IMT) and total plaque area (TPA) in patients with retinal vascular occlusion.

METHODS: A total of 63 consecutive vascular occlusive retinopathy patients with carotid atherosclerosis were enrolled. We examined changes in the carotid IMT/TPA and visual acuity/macular thickness before and after 1-year treatment with cilostazol (200 mg/day).

RESULTS: The mean IMT of both common carotid arteries (CCAs) and internal carotid arteries (ICAs) were significantly reduced after cilostazol treatment. There was no significant difference in the TPA of both CCAs before and after the treatment (before; 0.61 ± 0.94 vs. after; 0.45 ± 0.79 cm(2) , P = 0.291); however, significant plaque regression (before; 0.14 ± 0.15 vs. after; 0.25 ± 0.14 cm(2) , P = 0.004) was observed in selected patients (n = 30) with a TPA <0.5 cm(2) . The improvement in macular thickness was significantly associated with an improvement in carotid IMT (r = 0.42, P = 0.001) and TPA (r = 0.23, P = 0.04).

CONCLUSION: Cilostazol potently inhibited the progression of carotid IMT and may play a role in the early carotid plaque regression in patients with retinal vascular occlusion.