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Abstract #3581 Published in IGR 4-2
Experience with Ramipril (Triatec®) in the treatment of glaucomatous neuropathy
Rekik RJournal Français d'Ophtalmologie 2002; 25: 357-365
PURPOSE: The main purpose of this study was to assess the improvement in visual function in patients with glaucomatous neuropathy treated with Ramipril (angiotensin-converting enzyme inhibitor); the authors were thus able to link ischemia and visual deterioration in glaucoma. Ramipril increases endothelium-dependent relaxation and vasodilatation to bradykinin via B2 receptors linked to the formation of nitric oxide (NO). On the other hand, Ramipril could have an influence on retinal neurotransmission modulation. MATERIAL AND METHODS: Ramipril was administered to 22 patients suffering from chronic glaucoma in whom intraocular pressure (IOP) was controlled by classic treatment, combining Ramipril with this treatment. It was given orally (1.25 mg daily) for three months in order to improve visual function. In addition to the standard follow-up (visual acuity, intraocular pressure, automatic perimetry, optic disc), this study focused on the systemic tolerance to Ramipril. RESULTS: Thirty eyes in 22 patients were evaluated. Mean IOP did not change, but the mean visual acuity improved from 0.53 to 0.74. After three months of treatment, the perimetric test (Octopus) showed an improvement in the mean defect (48%) and the corrected loss variance (54%). No complications in terms of arterial pressure were observed. CONCLUSIONS: This study has shown that Ramipril was an effective agent in glaucomatous neuropathy. It improved visual function without changing IOP and had a satisfactory general tolerance in all patients. This could be explained in part by a higher production of NO by endothelial cells. This gas is a powerful vasodilator. It is formed from L-arginine by constitutive nitric oxide synthetase. This would provide an improvement in local blood flow autoregulation altered in glaucoma by an endothelial dysfunction. LA: French
Dr. R. Rekik, 3 avenue Louis Braille, 1002 Tunis, Tunisia
Classification:
11.7 Treatment of bloodflow (Part of: 11 Medical treatment)
