Effects of Timolol and Dorzolamide on Retrobulbar Hemodynamics in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

Galassi, F.; Sodi, Andrea; Renieri, Giulia; Ucci, Francesca; Pieri, B.; Harris, Alon; Siesky, Brent

doi:10.1159/000048311

Cited by 40 publications

(25 citation statements)

References 39 publications

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“…In agreement with our results, Galassi and colleagues 17 found a signifi cant decrease in RI in the temporal posterior ciliary artery after 4 weeks of dorzolamide 2% in patients with newly diagnosed POAG. However, the results of our study are in contradiction to the fi ndings reported by Bergstrand and colleagues 23 in previously untreated glaucoma patients.…”

Section: Discussionsupporting

confidence: 93%

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A Comparison of the Long-Term Effects of Dorzolamide 2% and Brinzolamide 1%, Each Added to Timolol 0.5%, on Retrobulbar Hemodynamics and Intraocular Pressure in Open-Angle Glaucoma Patients

Martínez

Sánchez-Salorio²

2009

Journal of Ocular Pharmacology and Therapeutics

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Purpose: To compare the effect on the retrobulbar hemodynamics and intraocular pressure (IOP) of dorzolamide 2% and brinzolamide 1%, each added to timolol 0.5% in patients with primary open-angle glaucoma (POAG). Methods: 146 POAG patients were prospectively randomized to receive either dorzolamide 2% or brinzolamide 1% BID, each added to timolol 0.5%, during a 60-month evaluator-masked study. At baseline and every 6 months for 60 months, we measured the retrobulbar hemodynamic parameters in the ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCA) using color Doppler imaging (CDI), intraocular pressure (IOP), and blood pressure measurements. Results: Dorzolamide signifi cantly increased the end-diastolic velocity (EDV) in the OA in 1.22 cm/s, 95% confi dence interval (95% CI) 0.90-1.56 cm/s, P < 0.001 and reduced the resistivity index (RI) in the OA in 0.04 units, 95% CI 0.03-0.05, P < 0.001. None of the retrobulbar parameters changed signifi cantly on therapy with brinzolamide when the results were analyzed at month 60. Both dorzolamide and brinzolamide signifi cantly decreased IOP (-4.3, 95% CI -4.5 to -4.2 mmHg and -4.3, 95% CI -4.4 to -4.2 mmHg, respectively). Dorzolamide significantly reduced the RI in the OA from 0.74 (0.02) to 0.70 (0.02), CRA from 0.66 (0.02) to 0.62 (0.02), and SPCA from 0.66 (0.02) to 0.62 (0.02), P < 0.001, respectively. Conclusions: Our results suggest augmented retrobulbar blood fl ow after 5 years of treatment with dorzolamide but not with brinzolamide, each added to timolol, in POAG patients.

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Section: Discussionsupporting

confidence: 93%

“…[15][16][17][18][19][20] However, not all studies have reported a positive outcome. [21][22][23] Relatively few studies have evaluated the effect of topical brinzolamide upon OBF in glaucoma patients.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of the Long-Term Effects of Dorzolamide 2% and Brinzolamide 1%, Each Added to Timolol 0.5%, on Retrobulbar Hemodynamics and Intraocular Pressure in Open-Angle Glaucoma Patients

Martínez

Sánchez-Salorio²

2009

Journal of Ocular Pharmacology and Therapeutics

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“…28 Using colour Doppler imaging, Martinez et al 29 found that most haemodynamic parameters of intraocular and periocular vessels improve after application of topical dorzolamide in both normal and glaucomatous eyes. In newly diagnosed POAG patients, Galassi et al 30 observed a significant reduction of resistivity index at the temporal short posterior ciliary artery. Dorzolamide has also been shown to significantly increase pulsatile ocular blood flow (POBF) in glaucoma patients.…”

Section: Introductionmentioning

confidence: 97%

The effects of dorzolamide 2% and dorzolamide/timolol fixed combination on retinal and optic nerve head blood flow in primary open-angle glaucoma patients

Rolle

Tofani

Brogliatti

et al. 2008

Eye

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Purpose To compare the effect of dorzolamide hydrochloride 2%, timolol maleate 0.5%, and their fixed combination on intraocular pressure (IOP) and retinal and optic nerve head haemodynamics in primary open-angle glaucoma patients. Methods Twenty-eight patients with early-moderate glaucomatous damage treated with b-blockers (46 months) with IOP values ranging from 18 to 22 mmHg at trough participated in this trial. After a 4-week washout period, patients were randomized in two groups: group I started with dorzolamide 2% monotherapy and group II with timolol 0.50% monotherapy for 4 weeks. After this period, both groups switched to dorzolamide/ timolol fixed combination for 4 weeks. IOP, ocular diastolic perfusion pressure (ODPP), heart rate, and Scanning Laser Doppler Flowmetry measurements at the peripapillary retina and neuroretinal rim were taken at T0 (enrolment), T1 (wash out), T2 (monotherapy), and T3 (dorzolamide/timolol). Data were compared between different study times. Statistical analysis was conducted using a paired t-test. Results Between T1 and T3, IOP decreased significantly in group I (À21.40%) (Po0.001) and in group II (À21.25%) (Po0.001). At the same time intervals, blood flow increased significantly at rim level for group I ( þ 30.03%) (Po0.05) and also when all patients were considered (rim þ 17.99%) (Po0.05). Between T1 and T3, we also observed a significant increase of ODPP in group I ( þ 7.24%) (Po0.01) and in group II ( þ 6.08%) (Po0.05) and when all patients were considered ( þ 8.43%) (Po0.01). Conclusions Dorzolamide/timolol fixed combination increased blood flow significantly at the neuroretinal rim showing a combination of hypotensive and haemodynamic effects.

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“…Even though CDI allows measurement of velocity and vascular resistivity but not the quantity of blood flow or O 2 tissue saturation, it is accepted as a reliable tool for indirect evaluation of ocular hemodynamics [25, 30]. To relate the systolic and diastolic velocities with each other, the RI value is used [25].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Bimatoprost and Travoprost: Effect on Intraocular Pressure and Ocular Circulation in Newly Diagnosed Glaucoma Patients

Alagöz

Gürel²,

Bayer³

et al. 2008

Ophthalmologica

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Background: This study compares intraocular pressure (IOP)-lowering efficacy and retrobulbar hemodynamic effects of bimatoprost and travoprost in patients with newly diagnosed open-angle glaucoma. Methods: Patients were randomly assigned to one of two treatment groups (bimatoprost group, n = 36; travoprost group, n = 46). IOP levels were measured with Goldmann applanation tonometer. Peak systolic velocity, end-diastolic velocity and resistivity index were obtained for each vessel by color Doppler imaging. Results: Both bimatoprost and travoprost significantly lowered IOP on days 30, 90 and 180 (p < 0.001). There was no significance between the 2 drugs on all follow-up visits. End-diastolic velocity of central retinal artery on day 180 was significantly higher than the value obtained at baseline in both groups. Conclusions: Patients were likely to achieve and maintain low target IOP with both drugs. Both drugs also resulted in improvement in the central retinal artery blood flow.

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Effects of Timolol and Dorzolamide on Retrobulbar Hemodynamics in Patients with Newly Diagnosed Primary Open-Angle Glaucoma

Cited by 40 publications

References 39 publications

A Comparison of the Long-Term Effects of Dorzolamide 2% and Brinzolamide 1%, Each Added to Timolol 0.5%, on Retrobulbar Hemodynamics and Intraocular Pressure in Open-Angle Glaucoma Patients

A Comparison of the Long-Term Effects of Dorzolamide 2% and Brinzolamide 1%, Each Added to Timolol 0.5%, on Retrobulbar Hemodynamics and Intraocular Pressure in Open-Angle Glaucoma Patients

The effects of dorzolamide 2% and dorzolamide/timolol fixed combination on retinal and optic nerve head blood flow in primary open-angle glaucoma patients

A Comparative Study of Bimatoprost and Travoprost: Effect on Intraocular Pressure and Ocular Circulation in Newly Diagnosed Glaucoma Patients

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