Short-Term Effects of Brimonidine/Timolol and Dorzolamide/Timolol on Ocular Perfusion Pressure and Blood Flow in Glaucoma

Siesky, Brent; Harris, Alon; Ehrlich, Rita; Cantor, Louis B.; Shoja, Mohammadali Mohajel; Rusia, Deepam; Hollander, David; Abrams, Leslie; Williams, Julia; Shoshani, Yochai Z.

doi:10.1007/s12325-011-0092-3

Cited by 6 publications

(7 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…By contrast to these findings Siesky et al [26] found that brinzolamide and dorzolamide may provide an increase in retinal oxygen saturation in patients with primary open angle glaucoma without any influence on the retrobulbar blood supply. In another published study Siesky et al [19] also compared the effects of dorzolamide/timolol and brimonidine/timolol combinations on ocular blood flow in a 1‐month period and found the same results with their previous study. Both studies included 15 primary open angle glaucoma patients.…”

Section: Discussionsupporting

confidence: 62%

“…Since Harris et al [9] reported topical dorzolamide accelerated the blood velocity in the retinal and superficial optic nerve head but had no effect on retrobulbar hemodynamics, several studies have been conducted to achieve a clear and distinct result regarding the relationship between topical CAI and retrobulbar blood flow [3,9,16–21]. Although dorzolamide alone is not the most potent agent to lower IOP, compared with surgery or even with other topical antiglaucoma medications, it has a dual action, the vasodilating and IOP lowering effect.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of dorzolamide/timolol fixed combination on retrobulbar hemodynamics in pseudoexfoliative glaucoma

Eliacik

Erdur

Altıok

et al. 2016

The Kaohsiung J of Med Scie

View full text Add to dashboard Cite

In our study we aimed to evaluate the short-term effects of dorzolamide/timolol on ocular perfusion pressure and retrobulbar blood flow in patients with pseudoexfoliative glaucoma (PXG). This prospective observational cross-sectional study enrolled 22 eyes of 22 newly-diagnosed patients with PXG in a single center. All of the patients received a fixed combination of dorzolamide/timolol. Besides routine ophthalmologic examination, the retrobulbar hemodynamic parameters in the ophthalmic artery, central retinal artery, and short posterior ciliary arteries were measured in all participants at baseline and the 3(rd) month using color Doppler imaging. The mean intraocular pressure (IOP) was 22.3 ± 2.1 mmHg at baseline and reduced to 17.4 ± 2.3 mmHg at the 3(rd) month (p < 0.05). None of the retrobulbar parameters, except peak systolic velocity and resistive index in temporal short posterior ciliary arteries, changed significantly on therapy with dorzolamide/timolol fixed combination when the results were analyzed at Month 3. The drug significantly decreased the peak systolic velocity (p = 0.044) and reduced the resistive index in 0.04 units, 95% confidence interval 0.03-0.05, (p < 0.001) in the temporal short posterior ciliary arteries. This study reports that the retrobulbar hemodynamics might be affected less than expected by dorzolamide/timolol fixed combination in patients with PXG although the reduction of IOP was statistically significant.

show abstract

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Effects of dorzolamide/timolol fixed combination on retrobulbar hemodynamics in pseudoexfoliative glaucoma

Eliacik

Erdur

Altıok

et al. 2016

The Kaohsiung J of Med Scie

View full text Add to dashboard Cite

show abstract

“…After application of brimonidine, reduced blood flow in the choroid was observed by Weigert et al3 and in the ciliary body by Reitsamer et al1 These findings are in accordance with our findings. However, other authors found no significant effect on OBF, particularly at the back of the eye in glaucoma patients 28–32…”

Section: Discussionmentioning

confidence: 88%

Effects of the Glaucoma Drugs Latanoprost and Brimonidine on Corneal Temperature

Konieczka

Koch

Hauenstein

et al. 2019

Trans. Vis. Sci. Tech.

View full text Add to dashboard Cite

Purpose The aim of this study was to investigate the effects of the glaucoma drugs latanoprost, brimonidine, and the combination of both on the central corneal temperature (CT) of healthy subjects by means of infrared thermography. Changes of the central CT may reflect changes of ocular blood flow. Methods Before application and during 2 hours after the application of latanoprost, brimonidine, or the combination of both in one eye, the CT in both eyes of 40 healthy subjects was measured repeatedly. Results Brimonidine reduced CT by approximately 0.5°C. This effect was statistically significant ( P < 0.0001). Latanoprost, however, had a very small and insignificant influence ( P = 0.47). Accordingly, the combination of brimonidine and latanoprost also reduced CT up to 0.5°C, and this effect was statistically significant ( P < 0.0001). Conclusions Brimonidine, but not latanoprost, had a significant effect on central CT. This cooling effect of brimonidine is most probably due to a drug-induced reduction of blood circulation in the ciliary body and iris and to a certain extent also to a reduction of blood flow in the fundus of the eye. Translational Relevance This study shows evidence that thermography of the cornea provides indirect information on the influence of drugs on the blood flow to the anterior segment of the patient's eye.

show abstract

“…The pre-OCTA literature suggests that while IOP decreases in glaucoma patients treated with topical timolol, OBF does not increase 59 , 60 and often declines. 61 , 62 Many studies confirm, however, that treatment with timolol in combination with dorzolamide 63 , 64 or, as was more recently demonstrated, brimonidine 64 elevates OBF in addition to lowering IOP. In our study, in all cases but one, timolol treatment was provided in combination with dorzolamide and/or brimonidine, so we do not expect medication use to have caused reduced OBF.…”

Section: Discussionmentioning

confidence: 90%

Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance

Richter¹,

Sylvester²,

Chu³

et al. 2018

OPTH

View full text Add to dashboard Cite

PurposeTo quantify peripapillary microvasculature within the retinal nerve fiber layer (RNFL) in primary open-angle glaucoma (POAG) and normal eyes, determine association of perfusion parameters with structural and functional measures, and report diagnostic accuracy of perfusion parameters.Patients and methodsPOAG and normal patients underwent 6×6 mm2 optic nerve head scans (Angioplex optical coherence tomography angiography [OCTA]; Cirrus HD-OCT 5000) and Humphrey Field Analyzer II-i 24-2 visual field (VF) testing. Prototype software performed semiautomatic segmentation to create RNFL en face images and quantified vessel area density (VAD), vessel skeleton density (VSD), and vessel complexity index (VCI) in the optic nerve head globally and focally. Generalized estimating equations models assessed association of OCTA parameters with VF mean deviation (MD) and RNFL thickness.ResultsThirty-eight POAG and 17 normal eyes were studied. Global VAD, VSD, and VCI were reduced in mild POAG vs normal (P<0.02) and moderate-severe vs mild POAG (P<0.04). Stepwise focal reductions across disease stage were demonstrated for OCTA parameters in the inferior hemisphere (P<0.05); reduction in OCTA parameters in mild POAG vs normal was demonstrated in inferior and superior quadrants (P<0.05). Reduced global VF MD was associated with reduced VAD, VSD, and VCI (P=0.0007, 0.0013, <0.0001; R2=0.449, 0.312, 0.399, respectively), and global RNFL thickness was associated with VAD, VSD, and VCI (P<0.0001; R2=0.499, 0.524, 0.542), superior and inferior hemifield MD were associated with corresponding VAD, VSD, and VCI (P≤0.001; R2 from 0.208 to 0.513). RNFL thickness in all quadrants was associated with corresponding OCTA parameters (P<0.05; R2 from 0.213 to 0.394), except temporal VAD and VCI. Area under curves for VAD, VSD, and VCI demonstrated good diagnostic ability (0.868, 0.855, 0.868; P<0.0001).ConclusionGlaucomatous eyes showed stepwise reductions in RNFL microcirculation across severity; focal reductions in the inferior hemisphere and inferior and superior quadrants were most significant. OCTA parameters had stronger associations with structural rather than functional measures of glaucoma.

show abstract

Short-Term Effects of Brimonidine/Timolol and Dorzolamide/Timolol on Ocular Perfusion Pressure and Blood Flow in Glaucoma

Abstract: Introduction: To examine the comparative

Cited by 6 publications

References 24 publications

Effects of dorzolamide/timolol fixed combination on retrobulbar hemodynamics in pseudoexfoliative glaucoma

Effects of dorzolamide/timolol fixed combination on retrobulbar hemodynamics in pseudoexfoliative glaucoma

Effects of the Glaucoma Drugs Latanoprost and Brimonidine on Corneal Temperature

Peripapillary microvasculature in the retinal nerve fiber layer in glaucoma by optical coherence tomography angiography: focal structural and functional correlations and diagnostic performance

Contact Info

Product

Resources

About