Effect of nimodipine on ocular blood flow and colour contrast sensitivity in patients with normal tension glaucoma

Abstract

Aim: To investigate the effects of oral nimodipine on ocular haemodynamic parameters and colour contrast sensitivity in patients with normal tension glaucoma (NTG). Design: The study was performed in a randomised, placebo controlled, double masked, crossover design. Participants: Nimodipine (60 mg) or placebo was administered to 14 consecutive NTG patients. Methods: The effects or oral nimodipine or placebo on ocular and systemic haemodynamic parameters and colour contrast sensitivity along the tritan axis were studied two hours after administration. Optic nerve head blood flow (ONHBF) and choroidal blood flow (CHBF) were assessed with laser Doppler flowmetry. Ocular fundus pulsation amplitude (FPA) was measured with laser interferometry. Colour contrast sensitivity (CCS) was determined along the tritan colour axis. Main outcome measures: ONHBF, CHBF, FPA, intraocular pressure and CCS were assessed in patients with NTG. Results: Mean ocular FPA increased by 14% (SD 14%) (p = 0.0008), ONHBF by 18% (SD 16%) (p = 0.0031), and CHBF by 12% (SD 14%) (p,0.001) after administration of nimodipine. Nimodipine also decreased the threshold of colour contrast sensitivity along the tritan colour axis (214% (SD 12%); p = 0.048). However, individual changes in FPA, ONHBF, or CHBF were not correlated with changes in threshold of CCS along the tritan colour axis. Conclusions:The results indicate that nimodipine increases ONH and choroidal blood flow in NTG patients and improves CCS. The latter effect does not, however, seem to be a direct consequence of the blood flow improvement.

Effect of Flunarizine, a Calcium Channel Blocker, on Intraocular Pressure and Aqueous Humor Dynamics in Monkeys

“…[6][7][8][9][10] Calcium antagonists have also been investigated as potential neuroprotective agents due to their role in modulating intracellular calcium levels and their effects on vascular smooth muscle. [9][10][11][12][13][14][15][16] A drug that combines an ocular hypotensive with a neuroprotective effect may be especially effective in the treatment of glaucoma, given the complexity of the underlying disease mechanisms. Flunarizine, a nonselective calcium channel blocker of L-type and T-type calcium channels, has been shown both to reduce IOP and to be neuroprotective in various experimental models.…”

Effect of Korean Red Ginseng Supplementation on Ocular Blood Flow in Patients with Glaucoma

“…Therefore, improving ocular blood flow may help the treatment of glaucoma. Several topical and systemic agents have been shown to improve ocular circulation in patients with glaucoma [17][18][19][20][21].…”

Glaucoma de pressão normal

“…Também os bloqueadores de canais de cálcio, como nimodipina e nilvadipina, têm uma aplicação potencial no tratamento do GPN, pelo provável efeito benéfico sobre a hemodinâmica retrobulbar (103)(104) . Um ensaio clínico que comparou o efeito da nimodipina versus placebo em pacientes com NTG, pela fluxometria Doppler, mostrou que essa substância aumentou o fluxo sangüíneo coroidal e da cabeça do nervo óptico e melhorou a sensibilidade ao contraste/cor (105) . Entretanto, um estudo brasileiro, com Doppler colorido, não mostrou melhora dos parâme-tros hemodinâmicos em pacientes com GPN em uso de nimodipina (106) .…”