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Abstract #6849 Published in IGR 4-1
Antiglaucomatous drugs effects on optic nerve head flow: Design, baseline and preliminary report
Sampaolesi J; Tosi J; Darchuk V; Ucha RA; Marengo J; Sampaolesi RInternational Ophthalmology 2001; 23: 359-367
PURPOSE: To determine the effect of the most frequently used antiglaucomatous drugs on optic nerve head flow. To note the response of the autoregulation system in hypertensive, preperimetric, and advanced perimetric glaucoma. MATERIAL: In this preliminary report, optic nerve head parameters and retinal perfusion values were measured in 25 healthy controls as well as in 72 glaucomatous optic nerve heads. The glaucomatous sample was divided into three groups: 24 eyes treated with betaxolol, 24 with brinzolamide, and 24 treated with brimonidine (each of these groups was formed of eight cases of hypertensive glaucoma, eight of preperimetric glaucoma, and eight of perimetric glaucoma). METHODS: Patients were examined with scanning laser Doppler flowmetry (wave length, 638 nm), and flow, volume and velocity indices were assessed in each report. Perfusion maps were analyzed with the new SLDF software, version 3.2 (automatic full field perfusion image analyzer). Examinations were also performed with the Heidelberg Retina Tomograph (wave length, 638 nm), using the new standard reference plane. Visual fields were performed with the Octopus 123 or 101 perimeters, programs G1x and G2, with three phases completed. Diurnal pressure curve with applanation tonometry and gonioscopy (for classification) were also performed. RESULTS: In this preliminary report, it was found that eyes in the hypertensive or preperimetric stages of glaucoma, seem to use their regulation systems in order to preserve their optic nerve head circulation, while cases of advanced perimetric glaucoma do not seen to be able to preserve their optic nerve head flow. Moreover, antiglaucomatous drugs were not able to increase optic nerve head flow neither. DISCUSSION: Optic nerve head blood supply is regulated by an autoregulation system. This phenomenon may act in normals, and in cases of hypertensive and preperimetric glaucoma, but it does not seem to be able to preserve the blood flow in advanced glaucoma. Optic nerve head flow returns to normal values with treatment in the first stages of glaucoma, while it seems that it cannot be restored in advanced glaucoma.
Dr. J. Sampaolesi, Department of Ophthalmology, University of Buenos Aires, School of Medicine, Buenos Aires, Argentina
Classification:
11.7 Treatment of bloodflow (Part of: 11 Medical treatment)
