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Abstract #18369 Published in IGR 3-3
Color Doppler imaging study in patients with primary open-angle glaucoma treated with timolol 0.5% and carteolol 2%
Montanari P;
Marangoni P;
Oldani A;
Ratiglia R;
Raiteri M;
Berardinelli LEuropean Journal of Ophthalmology 2001; 11: 240-244
PURPOSE: To evaluate with color Doppler imaging (CDI), in patients with primary open-angle glaucoma (POAG), the possible influence on ocular hemodynamics of a beta-blocking agent with intrinsic sympathomimetic activity (carteolol 2%), compared to a beta-blocker agent without this activity. METHODS: A study was carried out on 20 patients, with bilateral POAG, intraocular pressure (IOP) 20 mmHg, all treated twice a day with timolol maleate 0.5% ophthalmic solution. The visual field was evaluated (Octopus 2000 perimeter, G1 program), examining mean sensitivity (MS) and mean defect (MD). CDI was carried out to evaluate the resistance index of the internal carotid artery (ICA), ophthalmic artery (OA), central retinal artery (CRA), and short posterior ciliary arteries (SPCA). After these examinations, therapy was changed to carteolol 2% twice a day. After six months of treatment, the examinations were repeated. The data were analyzed statistically using Student's t test. RESULTS: The mean IOP during treatment with timolol 0.5% was 16.7 ± 1.67 mmHg and 16.33 ± 1.72 mmHg after treatment with carteolol 2%, the difference not being significant (p = 0.494). After six months of treatment with carteolol 2%, MS increased significantly from 22.4 ± 2.5 dB to 24.1 ± 1.8 dB (p = 0.018), and MD fell from 5.3 ± 0.8 dB to 4.7 ± 0.6 dB (p = 0.011). There was no significant difference in the resistance index of the CA, OA or CRA with the two treatments, whereas the resistance index of the SPCA dropped significantly, from 0.80 ± 0.05 to 0.77 ± 0.02 (p = 0.017). CONCLUSIONS: CDI did not show significant differences in the resistance indexes of the ICA, OA, or CRA after treatment with carteolol 2%, but the resistance index of the SPCA was significantly reduced. Carteolol 2% induced significant changes in the perimetric indexes examined, with an increase in MS and a decrease in MD. These findings suggest that the intrinsic sympathomimetic activity of carteolol may reduce peripheral vascular resistance of the SPCA, thus improving perfusion of the optic nerve head, with a protective effect on visual function.
Dr P. Montanari, Clinica Oculistica, University di Milano, Ospedale Maggiore IRCCS, Via F. Sforza 35, 20122 Milano, Italy. roberto.ratiglia@unimi.it
Classification:
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
