Effects of glaucoma drugs on ocular hemodynamics in normal tension glaucoma: a randomized trial comparing bimatoprost and latanoprost with dorzolamide [ISRCTN18873428].
BACKGROUND
Reduced choroidal perfusion is hypothesized to play a role in the pathogenesis of normal tension glaucoma. Thus the impact of antiglaucomatous eye drops on ocular perfusion has been the focus of recent research and the subject of intensive investigations. The present study investigates whether topically applied latanoprost or bimatoprost influence ocular perfusion in patients with normal tension glaucoma and compares these effects with that changes detected after the treatment with dorzolamide.


METHODS
Ocular hemodynamics were assessed by color Doppler imaging (CDI) shortly before and after a one-month treatment with either latanoprost, bimatoprost or dorzolamide. Primary end-points of the study were peak systolic and end-diastolic blood flow velocities in the short posterior ciliary artery (SPCA) under the new therapy. Intraocular pressure (IOP) and additional perfusion parameters in the SPCA and other retrobulbar vessels were tracked as observational parameters. n = 42 patients with normal tension glaucoma were enrolled in the study.


RESULTS
Systolic and diastolic blood flow velocities in the SPCA showed no significant alteration after the treatment with latanoprost or bimatoprost. Dorzolamide lead to increase of peak systolic velocity. IOP was reduced by all three agents in a range reported in the literature.


CONCLUSIONS
Topically applied latanoprost and bimatoprost act in a hemodynamically neutral manner and have the capability to lower IOP even in patients with normal tension glaucoma and low initial IOP level. Dorzolamide accelerates blood flow in systole. None of the tested compounds has a negative impact on hemodynamics in the short posterior ciliary arteries.
Zeitz
Oliver
O
Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde, Martinistr, 52, D-20246 Hamburg, Germany. zeitz@uke.uni-hamburg.de
Matthiessen
Eike T
ET
Reuss
Juliane
J
Wiermann
Anne
A
Wagenfeld
Lars
L
Galambos
Peter
P
Richard
Gisbert
G
Klemm
Maren
M
D000287:Administration, Topical; D000577:Amides; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D000069580:Bimatoprost; D001783:Blood Flow Velocity; D019842:Ciliary Arteries / Q000000981:diagnostic imaging / Q000502:physiology*; D003008:Cloprostenol / Q000031:analogs & derivatives; D005123:Eye / Q000098:blood supply; D005902:Glaucoma, Open-Angle / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects / Q000502:physiology*; D000077338:Latanoprost; D008055:Lipids / Q000008:administration & dosage; D009880:Ophthalmic Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D011446:Prospective Studies; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage; D012039:Regional Blood Flow; D012161:Retinal Artery / Q000000981:diagnostic imaging / Q000502:physiology*; D016037:Single-Blind Method; D013449:Sulfonamides / Q000008:administration & dosage; D013876:Thiophenes / Q000008:administration & dosage; D018615:Ultrasonography, Doppler, Color
D000577:Amides; D000959:Antihypertensive Agents; D008055:Lipids; D009883:Ophthalmic Solutions; D011461:Prostaglandins F, Synthetic; D013449:Sulfonamides; D013876:Thiophenes; D003008:Cloprostenol; D000077338:Latanoprost; C062765:dorzolamide; D000069580:Bimatoprost