title: Topical dorzolamide increases pericentral visual function in age-related maculopathy: pilot study findings with short-wavelength automated perimetry.
abstract: OBJECTIVE
  Numerous studies have confirmed the enhancement of ocular circulation by carbonic anhydrase inhibitors (CAIs). Topical CAI treatment with dorzolamide averts the significant pericentral visual function loss accompanying retinal and choroidal vasoconstriction during acute hyperventilation-induced hypocapnia. This study was designed to discern whether dorzolamide might similarly enhance macular function in patients with age-related maculopathy (ARM).
  
  
  METHODS
  In a masked, placebo-controlled study, 40 patients with ARM and acuity > 20/50 were randomized to receive either dorzolamide or placebo for 12 weeks, thrice daily. After pre-study perimetric training, pericentral function (mean sensitivity) was quantified using Humphrey 10-2 short-wavelength automated perimetry (SWAP), before and after 12 weeks of topical therapy.
  
  
  RESULTS
  Dorzolamide-treated eyes demonstrated a significant increase in mean sensitivity of + 1.55 dB (p = 0.04); placebo-treated eyes showed no significant change (+ 0.58 dB; p = 0.10). Given the non-significant increase of mean sensitivity in the placebo-treated group, fewer than 100 subjects per group would be required to afford > 70% power to yield a significant direct comparative difference between treatment and placebo in a prospective, randomized study of equally short duration.
  
  
  CONCLUSIONS
  This study demonstrated a significant increase in short-wavelength sensitivity in ARM with dorzolamide and the lack thereof with placebo. These encouraging pilot study data suggest a potential role for topical CAIs in ARM patients, and establish objective parameters for prospective studies to further evaluate the effects of dorzolamide in ARM.
authors.affiliation: Department of Ophthalmology, Medical School of the Technical University of Aachen, Germany. andreas.remky@post.rwth-aachen.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Remky
authors.forename: Anke
authors.initials: A
authors.lastname: Weber
authors.forename: Oliver
authors.initials: O
authors.lastname: Arend
authors.forename: William Eric
authors.initials: WE
authors.lastname: Sponsel
mesh_terms: D000287:Administration, Topical; D000368:Aged; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D013876:Thiophenes / Q000627:therapeutic use*; D014792:Visual Acuity / Q000187:drug effects* / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000187:drug effects / Q000502:physiology
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D013449:Sulfonamides; D013876:Thiophenes; C062765:dorzolamide