Effect of treatment by medicine or surgery on intraocular pressure and pulsatile ocular blood flow in normal-pressure glaucoma.
OBJECTIVE
To study the effect of trabeculectomy and monotherapy with topical betaxolol, brimonidine and latanoprost on intraocular pressure (IOP) and pulsatile ocular blood flow (POBF) in patients with normal-pressure glaucoma (NPG).


METHODS
In this retrospective study NPG patients attending the glaucoma research unit at Moorfields Eye Hospital were reviewed. Patients treated by surgery or topical medication (betaxolol, brimonidine or latanoprost) who had pre- and post-treatment IOP and POBF measurements were studied. For those patients who were having treatment to both eyes, one eye was selected at random for analysis.


RESULTS
A total of 147 patients were reviewed. Forty-three eyes were receiving betaxolol 0.5%, 58 eyes latanoprost 0.005%, 23 eyes brimonidine 0.2% and 23 eyes had undergone trabeculectomy surgery. There were more female than male patients in all four groups, and the groups were similar with regards age. Pre-treatment IOP and POBF values were similar among the groups ( P=0.27, P=0.08 respectively). Post-treatment IOP values tended to be lower than pre-treatment values for all four groups. All groups had an increased POBF except for betaxolol, where POBF decreased.


CONCLUSIONS
Patients treated by trabeculectomy and those receiving topical latanoprost and brimonidine had lower IOP and higher POBF following treatment. The betaxolol-treated group, despite a slight decrease in IOP, had a decreased POBF. Lowering IOP by treatment may not necessarily be associated with an increase in POBF.
Poinoosawmy
D
D
Glaucoma Research Unit, Moorfields Eye Hospital, City Road, London, EC1V 2PD, UK.
Indar
A
A
Bunce
C
C
Garway-Heath
D F
DF
Hitchings
R A
RA
D000287:Administration, Topical; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015784:Betaxolol / Q000627:therapeutic use; D001783:Blood Flow Velocity; D000068438:Brimonidine Tartrate; D005123:Eye / Q000098:blood supply*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008297:Male; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic / Q000627:therapeutic use; D011673:Pulsatile Flow; D011810:Quinoxalines / Q000627:therapeutic use; D012189:Retrospective Studies; D014065:Tonometry, Ocular; D014130:Trabeculectomy / Q000379:methods*
D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic; D011810:Quinoxalines; D000068438:Brimonidine Tartrate; D000077338:Latanoprost; D015784:Betaxolol