Fluoxetine may improve visual field defects among patients with stroke-related vision loss

Fluoxetine may improve visual field defects among patients with stroke-related vision loss suggests a new study published in the Journal of Neuro-Ophthalmology

Poststroke homonymous hemianopia is disabling, and complete spontaneous recovery is rare. In this randomized, placebo-controlled, double-blind, pilot clinical trial, we tested whether fluoxetine enhances vision recovery after stroke.

They randomized 17 consecutive adults 1:1 to 90 days of fluoxetine 20 mg daily vs placebo within 10 days of an ischemic stroke causing isolated homonymous hemianopia. The primary end point was percent improvement in 24-2 automated perimetry at 6 months. Twelve participants completed the study. Clinical trial registration NCT02737930.

Results:

Intention-to-treat analysis of the primary end point, percent improvement in perimetric mean deviation, showed a nonsignificant benefit of fluoxetine (64.4%, n = 5) compared with placebo (26.0%, n = 7, one-tailed 95% confidence interval (CI) = (−2.13, ∞), P = 0.06). The original blind field completely recovered in 60% receiving fluoxetine and 14% receiving placebo (odds ratio = 7.22, one-tailed 95% CI = (0.50, ∞)).

These results suggest a trend in favor of fluoxetine for vision recovery after stroke and have the potential to inform the design of a larger multicenter trial.

Reference:

Schneider, Colleen L. PhD; Prentiss, Emily K. BS; Busza, Ania MD, PhD; Williams, Zoë R. MD; Mahon, Bradford Z. PhD; Sahin, Bogachan MD, PhD. FLUORESCE: A Pilot Randomized Clinical Trial of Fluoxetine for Vision Recovery After Acute Ischemic Stroke. Journal of Neuro-Ophthalmology 43(2):p 237-242, June 2023. | DOI: 10.1097/WNO.0000000000001654

Keywords:

Fluoxetine, may, improve, visual field, defects, among, patients, stroke-related, vision loss,Journal of Neuro-Ophthalmology, Schneider, Colleen L. PhD; Prentiss, Emily K. BS; Busza, Ania MD, PhD; Williams, Zoë R. MD; Mahon, Bradford Z. PhD; Sahin, Bogachan