Nimodipine, a centrally active calcium antagonist, exerts a beneficial effect on contrast sensitivity in patients with normal-tension glaucoma and in control subjects.
OBJECTIVE
The use of calcium antagonists in patients with normal-tension glaucoma (NTG) currently is under investigation. The aim of this study is to evaluate the effect of an acute dose of oral nimodipine, a centrally active calcium antagonist, on spatial contrast sensitivity in patients with NTG and in age-matched control subjects.


METHODS
Spatial contrast sensitivity was measured using the Pelli-Robson and the Vistech 6000 charts in 14 patients with NTG and in 17 control subjects. Testing was performed at baseline and at two subsequent sessions. Measurements were recorded 2 hours after oral administration of either nimodipine or placebo in a randomized, double-masked manner. Data were analyzed using unpaired, two-tailed Student's t test for between-group comparisons and repeated measures analysis of variance for within-group comparisons.


RESULTS
Using the Pelli-Robson charts, baseline contrast sensitivity was significantly lower in patients with NTG compared with control subjects (P < 0.05, unpaired Student's t test). There was a significant increase in log contrast sensitivity after administration of nimodipine compared with baseline and placebo in patients with NTG (baseline, 1.39 +/- 0.38; placebo, 1.41 +/- 0.40; nimodipine, 1.51 +/- 0.39) and in control subjects (baseline, 1.62 +/- 0.11; placebo, 1.64 +/- 0.10; nimodipine, 1.81 +/- 0.14) (P < 0.05, repeated measures analysis of variance). A similar trend was observed using the Vistech charts.


CONCLUSIONS
These results suggest that central visual function as measured by Pelli-Robson and Vistech contrast sensitivity is impaired in eyes with NTG. An acute, oral administration of nimodipine, a calcium antagonist, improved contrast sensitivity in patients with NTG and in control subjects. The mechanism of this improvement is not fully understood. Further studies are needed to evaluate the effect of long-term administration in glaucoma.
Bose
S
S
Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia 19104, USA.
Piltz
J R
JR
Breton
M E
ME
D000368:Aged; D001794:Blood Pressure; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D015350:Contrast Sensitivity / Q000187:drug effects* / Q000502:physiology; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009553:Nimodipine / Q000627:therapeutic use*; D011446:Prospective Studies; D014792:Visual Acuity
D002121:Calcium Channel Blockers; D009553:Nimodipine