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Abstract #18381 Published in IGR 3-3
The one-month effects of topical betaxolol, dorzolamide and apraclonidine on ocular blood flow velocities in patients with newly diagnosed primary open-angle glaucoma
Avunduk AM; Sari A; Akyol N; Öztürk O; Kapicioglu Z; Erdöl H; Imamoglu HIOphthalmologica 2001; 215: 361-365
PURPOSE: This double-masked, prospective, randomized clinical trial was planned to investigate, with color Doppler imaging, the one-month vascular effects of betaxolol, dorzolamide, and apraclonidine treatment in patients with newly diagnosed primary open-angle glaucoma (POAG). METHODS: Twenty-two consecutive patients with newly diagnosed POAG aged between 46 and 72 years were enroled in this study. All patients were newly diagnosed cases and had not received any earlier antiglaucoma medication. Patients who had a systemic vascular disease (including systemic hypertension) or who were taking beta-blockers, nitrates, or calcium channel blockers were excluded from the study. The patients were randomly divided into three groups. Groups A and B included seven patients, group C eight patients. Group A patients were treated with topical betaxolol, group B received topical dorzolamide eye drops, and group C patients were treated with topical apraclonidine eye drops. Peak systolic velocities (PSV), end-diastolic velocities (EDV), and resistive indices (RI) in the right ophthalmic arteries (OA), central retinal arteries (CRA), and posterior ciliary arteries (PCA) were measured at baseline by using color Doppler imaging on a masked basis. On Days 15 and 30 of treatment, the measurements were repeated. The inter- and intragroup results were compared statistically. RESULTS: Compared to pretreatment measurements, topical betaxolol therapy significantly decreased PSV in the PCA only and only on Day 30 of treatment (p = 0.011). On Days 15 and 30, dorzolamide decreased RI measurements in the PCA compared to the pretreatment measurement (p = 0.013 and 0.011, respectively). Apraclonidine also decreased PSV in the OA on Days 15 and 30 of treatment when compared to pretreatment values (p = 0.013 and 0.012, respectively). When the 15-day measurements were compared between the groups, PSV in the OA were significantly higher in dorzolamide-treated patients compared to the other groups (p = 0.01 and 0.011). On Day 30 of treatment, PSV in the OA was also higher in the dorzolamide-treated group than in the other groups (p = 0.012 and 0.01). Additionally, apraclonidine-treated patients had a significantly lower EDV in the OA than the other groups (p = 0.013 and 0.01). The RI in the OA was also significantly lower in the apraclonidine-treated group compared to the other groups (p = 0.01 and 0.011). CONCLUSIONS: This study suggests that dorzolamide has the most advantageous one-month effects on blood flow velocity in the retrobulbar arterial circulation of POAG patients. Betaxolol seems to be superior to apraclonidine in this regard. These data may help the clinician when treating patients with POAG medically. Further studies using a larger population size may clarify these results.
Dr A.M. Avunduk, Department of Ophthalmology, Karadeniz Technical University, School of Medicine, Trabzon, Turkey
Classification:
11.3.3 Apraclonidine, brimonidine (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)