The effect of nimodipine, a centrally active calcium antagonist, on visual function and mascular blood flow in patients with normal-tension glaucoma and control subjects.
OBJECTIVE
This study was performed to evaluate the effect of nimodipine, a centrally active calcium channel antagonist on automated Humphrey visual fields, Farnsworth-Munsell 100 (FM-100) hue color vision testing, and macular blood flow (blue field entoptic simulation technique) in patients with normal-tension glaucoma (NTG) and control subjects.


METHODS
Thirteen patients with NTG and thirteen age- and sex-matched control subjects were studied in a prospective, placebo-controlled, double-masked, crossover protocol. On each of the two study dates, testing was performed at baseline and 90 minutes after administration of either two 30-mg nimodipine capsules or two identical appearing placebo capsules. Blood pressure and pulse were monitored throughout the study.


RESULTS
Nimodipine administration resulted in a performance corrected improvement in Humphrey visual field mean deviation (patients with NTG and control subjects), corrected pattern standard deviation (patients with NTG), and macular sensitivity (the average of the foveal threshold and the four most central points of the visual field; patients with NTG). The FM-100 hue error scores significantly decreased after administration of nimodipine in patients with NTG and control subjects compared with baseline. There were no significant differences in baseline leukocyte velocity or density between patients with NTG and control subjects; no significant changes in leukocyte velocity or density were noted after administration of nimodipine in either group.


CONCLUSIONS
Nimodipine caused a significant performance corrected improvement in visual field testing and a significant improvement in color vision. Nimodipine did not alter macular hemodynamics as measured using the blue field entoptic simulation technique, although results were hampered by high variability, particularly in the leukocyte density measurements.
Piltz
J R
JR
Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia, USA.
Bose
S
S
Lanchoney
D
D
D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D003118:Color Perception / Q000187:drug effects*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007429:Intraocular Pressure; D007962:Leukocytes / Q000502:physiology; D008266:Macula Lutea / Q000098:blood supply*; D008297:Male; D009553:Nimodipine / Q000627:therapeutic use*; D011446:Prospective Studies; D014792:Visual Acuity / Q000187:drug effects; D014794:Visual Fields / Q000187:drug effects*
D002121:Calcium Channel Blockers; D009553:Nimodipine