advertisement
Abstract #27110 Published in IGR 12-4
The additive effect of dorzolamide hydrochloride (Trusopt) and a morning dose of bimatoprost (Lumigan) on intraocular pressure and retrobulbar blood flow in patients with primary open-angle glaucoma
Stankiewicz A; Wierzbowska J; Siemiatkowska A; Fuksinska B; Robaszkiewicz J; Zegadlo A; Ehrlich R; Siesky B; Harris ABritish Journal of Ophthalmology 2010; 94: 1307-1311
Aims: To assess the additive effect of dorzolamide hydrochloride 2% on the diurnal intraocular pressure (IOP) curve and retrobulbar haemodynamics in patients with primary open-angle glaucoma (POAG) treated with morning-dosed bimatoprost 0.03%. Methods: Twenty-five patients with POAG were evaluated in a prospective, single-masked study. After a 1 week run-in period with bimatoprost all patients were treated with bimatoprost dosed once in the morning for 1 month, after which dorzolamide was added twice daily for 2 months. Goldmann applanation IOP, arterial blood pressure (ABP) and heart rate were measured every 2 h for 24 h and diurnal ocular perfusion pressure (OPP) was calculated. Colour Doppler imaging (CDI) of the ophthalmic artery (OA) and the central retinal artery (CRA) was recorded five times daily. All measurements were taken after the two phases of treatment and were compared. Results: The mean baseline IOP was 14.8(plus or minus)3.5 mmHg. Mean IOP following bimatoprost monotherapy (12.8(plus or minus)2.9 mmHg) and after 2 months of dorzolamide adjunctive therapy (12.2(plus or minus)2.6 mmHg) were not statistically significantly different (p=0.544). Only at the 4:00 h time point was IOP significantly reduced using the bimatoprost/dorzolamide combined treatment (p=0.013). The 24 h IOP fluctuations were lower when dorzolamide was added (6.0(plus or minus)2.3 mm Hg vs 4.6(plus or minus)1.5 mm Hg, p=0.0016). Repeated analysis of variance detected a significant decrease of vascular resistance in the OA (p=0.0167) with adjunctive dorzolamide treatment. Conclusions: The addition of dorzolamide to morning-dosed bimatoprost had an additive hypotensive effect only on the night-time IOP curve at 4:00 h and resulted in a lower IOP fluctuation. Dorzolamide added to bimatoprost may reduce vascular resistance in the OA.
J. Wierzbowska. Department of Ophthalmology, Military Health Service Institute, 128 Szaserow Str, 04-141 Warsaw 44, Poland. joanna.wierzbowska@gmail.com
Classification:
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)
6.1.3 Factors affecting IOP (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
11.5.2 Topical (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)
11.4 Prostaglandins (Part of: 11 Medical treatment)