A pilot study for the effects of donepezil therapy on cerebral and optic nerve head blood flow, visual field defect in normal-tension glaucoma.
OBJECTIVE
To evaluate the effect of donepezil hydrochloride, an agent for the treatment of Alzheimer's disease (AD), on the cerebral and optic nerve head (ONH) blood flow, visual field defect in normal-tension glaucoma (NTG) patients with decreased cerebral blood flow (CBF) that demonstrates an AD-like perfusion pattern.


METHODS
The subjects were 5 NTG patients who exhibited AD-like decreased CBF upon (123)I-iodoamphetamine single photon emission computed tomography ((123)I-IMP SPECT). Donepezil hydrochloride (5 mg/day) was prescribed for each patient during a period of 12 months. Intraocular pressure (IOP), mean deviation (MD) of the Humphrey visual field, ONH blood flow determined by a laser speckle flowgraphy, and regional CBF (rCBF) determined by (123)I-IMP SPECT were measured before and every 6 months during the treatment.


RESULTS
MD, ONH blood flow, and rCBF were improved significantly after 6 months of the treatment, although IOP did not change significantly. No deterioration of NTG morbidity was found in any of the measured parameters after 12 months of the treatment.


CONCLUSIONS
Oral administration of donepezil hydrochloride in NTG patients might prevent deterioration of visual field defect, ONH blood flow, and rCBF in the temporal, parietal, and posterior lobes. This pilot study suggested the possibility that donepezil hydrochloride might ameliorate glaucomatous optic neuropathy in NTG.
Yoshida
Yukiko
Y
Department of Ophthalmology, Ujigawa Hospital, vji, Kyoto, Japan.
Sugiyama
Tetsuya
T
Utsunomiya
Keita
K
Ogura
Yasuharu
Y
Ikeda
Tsunehiko
T
D000284:Administration, Oral; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D001921:Brain / Q000098:blood supply*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D000077265:Donepezil; D005260:Female; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D007429:Intraocular Pressure / Q000187:drug effects; D020367:Iofetamine; D017078:Laser-Doppler Flowmetry; D057066:Low Tension Glaucoma / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D009898:Optic Disk / Q000098:blood supply*; D010865:Pilot Projects; D010880:Piperidines / Q000627:therapeutic use*; D019275:Radiopharmaceuticals; D012039:Regional Blood Flow / Q000187:drug effects; D015899:Tomography, Emission-Computed, Single-Photon; D014786:Vision Disorders / Q000517:prevention & control*; D014794:Visual Fields / Q000187:drug effects
D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D019275:Radiopharmaceuticals; D000077265:Donepezil; D020367:Iofetamine