Relevance. The ability of antiglaucoma drugs to improve ocular hemoperfusion is an important aspect of their action. Tafluprost is the first prostaglandin analogue (PA) containing no preservatives.  The efficacy and safety of tafluprost, as well as tafluprost/timolol  fixed combination (FC), was demonstrated in randomized multicenter  trials. However, there is no literature on the effect of  tafluprost and it’s FC on peripapillary and macular blood flow.Purpose. to assess the effect of tafluprost and tafloprost/timolol on the microcirculation in the optic nerve head, peripapillary area and  macula in patients with primary open-angle glaucoma (POAG)  according to OCT angiography (OCT-A).Patients and methods. OCT-A was performed in dynamics with an interval of a week in 36 patients (36 eyes) with a newly diagnosed  initial stage of POAG, 12 received tafluprost, 12 — tafluprost/timolol  FCs, 12 eyes represented control group (no drugs were prescribed).  The change in IOP, mean perfusion pressure (PP) of the eye, and  vessel density (VD) inside the optic nerve head (ONH) (inside disc),  as well as in the peripapillary retina and macula were evaluated by  comparing paired repeated observations using the median growth analysis.Results. In the tafluprost group there was a decrease in IOP by 19.4 % and an increase in PP by 8.7 % from the reference level. In the  tafluprost/timolol group, these figures were 43 % and 30.1 %,  respectively. OCT-A values did not change reliably, except for VD  inside Disc: in the tafluprost group, the median growth was –2.28 (p = 0.02), for the tafluprost/ timolol group — –1.82 (p = 0.03). These  changes were obtained in 11 patients of 12 in each group under  treatment. In patients who did not receive treatment, all indicators  remained unchanged.Conclusions. The results of this study showed a decrease in the density of the microcirculatory bed in the ONH in patients with initial  glaucoma against the background of the tafluprost and  tafluprost/timolol treatment, which can be explained by the  restoration of autoregulation of the ocular blood flow in conditions of  pronounced hypotensive drugs effect.

Prostaglandinanalogues (PAs) are the drugs of choice in the treatment of primary open-angle glaucoma (POAG). However, they have pro-inflammatory properties and may cause macular edema. Tafluprost is the first PA to be free of preservatives. The efficacy and safety of tafluprost, as well as that of tafluprost/timolol fixed combination (FC), was demonstrated in randomized multicenter trials. However, there are no literary data concerning the effect of tafluprost and its FC on the thickness of the macula.Purpose. To assess the effect of tafluprost and tafloprost/timolol on the retinal thickness in the macular area in patients with POAG.Material and methods. The retinal thickness (RT) was measured with an interval of a week in 36 patients (36 eyes) with a newly diagnosed initial stage of POAG, 12 of whom were prescribed taflotan, 12 patients received tafluprost/timolol FC, and 12 eyes represented the control group (no drugs were prescribed). The measurements were performed in the macular area using a spectral domain optical coherence tomography (SD-OCT) by means of the RtVue xR Avanti with the AngioVue OCT angiography function. The change in the intraocular pressure (IOP) and RT from the inner limiting membrane (ILM) to the inner plexiform layer (inner retina) and to the pigment epithelium (PE) in fovea and parafovea in total and by sectors were estimated by comparing paired repeated observations using the median growth analysis.Results. In the tafluprost group, a 19.4 % IOP decrease was revealed and in the tafluprost/timolol group the decrease achieved 43 % with respect to the reference level. In patients receiving tafluprost, an increase in the RT in parafovea was noted: median growth 2 μm (p = 0.035); and in patients receiving tafluprost/timolol — in the inner layers of parafovea: median growth 3 μm (p = 0.031), and its inferior half: median growth 2.5 μm (p = 0.023). These changes were obtained in 10 patients out of 12 in each treated group. In untreated patients, the RT remained unchanged. The visual acuity did not change in any group of patients.Conclusions. In patients with glaucoma, a thickening of both the inner layers and the entire macular retina occurred within a week after treating with tafluprost or its FC, leaving no clinical manifestation. This fact should be taken into account in patients likely to develop macular edema.