comparison of the efficacy of aspirin, aspirin+dipyridamole and warfarin in patients with amaurosis fugax secondary to mitral valve prolapse

purpose : to determine the efficacy of three therapeutic regimens for the treatment of amaurosis fugax secondary to embolic sources from the heart methods : sixty patients randomly divided into 3 groups (20 patients in each group). group 1 received 100 mg aspirin/day, group 2 received the same dose of aspirin plus dipyridamole 75 mg twice daily and group 3 received 10 mg warfarin for 3 days followed 5 mg thereafter. all patients were followed every 6 months for relapse of amaurosis fugax and cardiac status. data were collected and analysed. results : forty-nine patients (81.6%) were female and 11 patients (18.4%) were males. the mean ages of patients in group 1, 2, 3 were 44.85±14.56, 45.55±15.49 and 4490±14.87, respectively (p=0.98). the mean duration of amaurosis fugax stroke was 7 minutes (ranged 4-11 minutes). 91.6% of the patients had type a personality by anxiety and neurosis. stroke was seen in 47 (78.3%) patients in both eyes, in 10 patients (16.6%) in the left eye and in 3 cases (5.1%) in the right eye. after one year of treatment, relapse of amaurosis fugax stroke was developed in 7 (35%) patients in aspirin group, 5 (25%) in aspirin plus dipyridamole group and 1 (5%) in warfarin group. warfarin group had lower relapse than those in other groups (p=0.022). conclusion : the results show that warfarin has better efficacy for the treatment of amaurosis fugax than aspirin or aspirin plus dipyridamole.   iranian journal of ophthalmology 201022(3):29-32 © 2010 by the iranian society of ophthalmology