title: Update and critical appraisal of combined timolol and carbonic anhydrase inhibitors and the effect on ocular blood flow in glaucoma patients.
abstract: Topical hypotensive therapy with both timolol and carbonic anhydrase inhibitors has been shown to be efficacious at reducing intraocular pressure. Many prospective studies have also suggested that carbonic anhydrase inhibitors augment ocular blood flow and vascular regulation independent of their hypotensive effects. Although consistent in their findings, these studies must be cautiously interpreted due to the limitations of study design and specific blood flow imaging modalities. The purpose of this review is to appraise and critically evaluate the current body of literature investigating the effects of combined treatment with topical carbonic anhydrase inhibitors and timolol in patients with glaucoma with respect to ocular blood flow, visual function, and optic nerve head structure.
authors.affiliation: Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Moss
authors.forename: Alon
authors.initials: A
authors.lastname: Harris
authors.forename: Brent
authors.initials: B
authors.lastname: Siesky
authors.forename: Deepam
authors.initials: D
authors.lastname: Rusia
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Williamson
authors.forename: Yochai
authors.initials: Y
authors.lastname: Shoshani
references.citation: Ophthalmology. 2005 Mar;112(3):366-75
references.pmid: 15745761
references.citation: Acta Ophthalmol Scand. 1998 Feb;76(1):43-9
references.pmid: 9541433
references.citation: Acta Ophthalmol Scand. 1996 Dec;74(6):569-72
references.pmid: 9017044
references.citation: J Glaucoma. 1995 Aug;4(4):281-6
references.pmid: 19920687
references.citation: Acta Ophthalmol Scand. 2001 Aug;79(4):336-41
references.pmid: 11453850
references.citation: Arch Ophthalmol. 1995 Feb;113(2):216-21
references.pmid: 7864755
references.citation: J Glaucoma. 1997 Jun;6(3):175-9
references.pmid: 9211141
references.citation: J Glaucoma. 1999 Jun;8(3):164-71
references.pmid: 10376255
references.citation: Am J Ophthalmol. 1995 Aug;120(2):168-75
references.pmid: 7639300
references.citation: Curr Eye Res. 1997 Nov;16(11):1102-10
references.pmid: 9395769
references.citation: J Glaucoma. 1999 Feb;8(1):12-7
references.pmid: 10084269
references.citation: Br J Ophthalmol. 2005 Oct;89(10):1293-7
references.pmid: 16170119
references.citation: J Ocul Pharmacol Ther. 2006 Oct;22(5):353-61
references.pmid: 17076630
references.citation: Acta Ophthalmol Scand. 2005 Dec;83(6):716-22
references.pmid: 16396650
references.citation: Am J Ophthalmol. 2006 Jun;141(6):1158-60
references.pmid: 16765700
references.citation: Ophthalmology. 2001 Nov;108(11):1943-53
references.pmid: 11713061
references.citation: Ophthalmology. 1998 Jul;105(7):1146-64
references.pmid: 9663215
references.citation: J Glaucoma. 2007 Dec;16(8):700-3
references.pmid: 18091458
references.citation: Am J Ophthalmol. 2000 Oct;130(4):429-40
references.pmid: 11024415
references.citation: Prog Retin Eye Res. 2000 Jan;19(1):87-112
references.pmid: 10614682
references.citation: Clin Ther. 2008 Jun;30(6):1120-34
references.pmid: 18640468
references.citation: Acta Ophthalmol Scand Suppl. 2002;236:55-6
references.pmid: 12390145
references.citation: Int J Clin Pract. 2007 May;61(5):815-25
references.pmid: 17343668
references.citation: Surv Ophthalmol. 2009 Jan-Feb;54(1):33-46
references.pmid: 19171209
references.citation: Eur J Ophthalmol. 2009 Sep-Oct;19(5):790-7
references.pmid: 19787599
references.citation: Ophthalmology. 2000 Jul;107(7):1287-93
references.pmid: 10889099
references.citation: Ophthalmology. 2008 Oct;115(10):1728-34, 1734.e1-2
references.pmid: 18538406
references.citation: J Ultrasound Med. 1991 Jun;10(6):305-8
references.pmid: 1895370
references.citation: Curr Med Res Opin. 2006 Jan;22(1):67-73
references.pmid: 16393432
references.citation: Br J Ophthalmol. 1998 Nov;82(11):1249-53
references.pmid: 9924327
references.citation: Ophthalmology. 1998 Oct;105(10):1952-9
references.pmid: 9787369
references.citation: J Ocul Pharmacol Ther. 2009 Jun;25(3):239-48
references.pmid: 19348600
references.citation: Res Commun Mol Pathol Pharmacol. 1999 Mar;103(3):240-8
references.pmid: 10509735
references.citation: Graefes Arch Clin Exp Ophthalmol. 2006 Jul;244(7):795-801
references.pmid: 16315043
references.citation: Curr Eye Res. 2005 Mar;30(3):221-7
references.pmid: 15804748
references.citation: Br J Ophthalmol. 1999 Apr;83(4):466-9
references.pmid: 10434872
references.citation: Arch Ophthalmol. 1995 Jul;113(7):918-24
references.pmid: 7605285
references.citation: Invest Ophthalmol. 1975 Dec;14(12):935-7
references.pmid: 1193808
references.citation: Arch Ophthalmol. 2003 Dec;121(12):1711-5
references.pmid: 14662590
references.citation: Am J Ophthalmol. 2003 May;135(5):664-9
references.pmid: 12719074
references.citation: Br J Ophthalmol. 2002 Nov;86(11):1216-9
references.pmid: 12386070
references.citation: Invest Ophthalmol Vis Sci. 1999 Sep;40(10):2448-53
references.pmid: 10476818
references.citation: Graefes Arch Clin Exp Ophthalmol. 2009 Nov;247(11):1531-8
references.pmid: 19760224
references.citation: Protein Sci. 1998 Mar;7(3):556-63
references.pmid: 9541386
references.citation: Acta Ophthalmol Scand. 2004 Dec;82(6):730-7
references.pmid: 15606472
references.citation: Ophthalmology. 2009 Feb;116(2):200-7
references.pmid: 19019444
references.citation: Invest Ophthalmol Vis Sci. 1987 Aug;28(8):1436-41
references.pmid: 3038771
references.citation: J Glaucoma. 1997 Feb;6(1):23-32
references.pmid: 9075077
references.citation: Am Heart J. 1980 Aug;100(2):160-78
references.pmid: 6105819
references.citation: Br J Ophthalmol. 2006 Oct;90(10):1245-8
references.pmid: 16825276
references.citation: Am J Ophthalmol. 1998 Oct;126(4):498-505
references.pmid: 9780094
references.citation: Eye (Lond). 1993;7 ( Pt 1):122-6
references.pmid: 8392006
references.citation: Br Med J. 1978 Dec 9;2(6152):1598-600
references.pmid: 728739
references.citation: Am J Ophthalmol. 2003 Dec;136(6):1022-31
references.pmid: 14644212
references.citation: Graefes Arch Clin Exp Ophthalmol. 2006 Aug;244(8):978-83
references.pmid: 16411100
references.citation: Eye (Lond). 1995;9 ( Pt 1):29-33
references.pmid: 7713247
references.citation: Acta Ophthalmol Scand. 2003 Oct;81(5):474-9
references.pmid: 14510794
references.citation: Br J Ophthalmol. 2000 Sep;84(9):1008-12
references.pmid: 10966955
references.citation: Am J Ophthalmol. 2001 Oct;132(4):490-5
references.pmid: 11589868
references.citation: Acta Ophthalmol. 2008 Aug;86(5):552-7
references.pmid: 18081900
references.citation: Arch Ophthalmol. 2002 Jun;120(6):701-13; discussion 829-30
references.pmid: 12049574
references.citation: Klin Monbl Augenheilkd. 1999 Dec;215(6):361-6
references.pmid: 10637801
references.citation: Ophthalmology. 1997 Apr;104(4):653-8
references.pmid: 9111259
references.citation: Eye (Lond). 1993;7 ( Pt 5):697-702
references.pmid: 8287997
references.citation: Arch Neurol. 1961 Aug;5:227-32
references.pmid: 13725995
references.citation: Ophthalmologica. 2002 Mar-Apr;216(2):123-8
references.pmid: 11919438
references.citation: J Clin Invest. 1978 Sep;62(3):585-92
references.pmid: 99455
references.citation: Ophthalmology. 2000 Mar;107(3):430-4
references.pmid: 10711877
references.citation: Retina. 2008 Mar;28(3):493-7
references.pmid: 18327144
references.citation: Ophthalmology. 1999 Nov;106(11):2144-53
references.pmid: 10571351
references.citation: Int Ophthalmol. 1998;22(5):299-305
references.pmid: 10826548
references.citation: Acta Ophthalmol. 2010 Aug;88(5):541-52
references.pmid: 19799592
references.citation: Acta Ophthalmol Scand. 2006 Aug;84(4):475-80
references.pmid: 16879567
references.citation: J Glaucoma. 1997 Jun;6(3):143-5
references.pmid: 9211135
references.citation: Am Heart J. 1973 Jan;85(1):97-102
references.pmid: 4629296
references.citation: Arch Ophthalmol. 2002 Oct;120(10):1268-79
references.pmid: 12365904
references.citation: Graefes Arch Clin Exp Ophthalmol. 2007 Nov;245(11):1639-45
references.pmid: 17457602
references.citation: Am J Ophthalmol. 1994 Nov 15;118(5):642-9
references.pmid: 7977577
references.citation: Open Ophthalmol J. 2009 Sep 17;3:38-42
references.pmid: 19816585
references.citation: Br J Ophthalmol. 1993 Jan;77(1):25-9
references.pmid: 8435394
references.citation: Br J Ophthalmol. 2004 Aug;88(8):1049-54
references.pmid: 15258023