Efecto de Combigan® versus placebo en el flujo sanguíneo ocular en pacientes hipertensos oculares
- B. Puerto-Hernández
- G. Rebolleda
- J.L. García-Pérez
- F.J. Muñoz-Negrete
- C. González-Gordaliza
ISSN: 0365-6691
Year of publication: 2011
Volume: 86
Issue: 2
Pages: 42-46
Type: Article
More publications in: Archivos de la Sociedad Española de Oftalmologia
Abstract
Purpose: This study was undertaken to compare the ocular haemodynamic effects of Combigan® versus placebo in patients with ocular hypertension (OHT). Methods: Thirty patients with OHT were included in a controlled, randomised, double blind study in two parallel groups; 15 were randomised to receive Combigan® and 15 to receive placebo for a period of 3 months. At baseline and at 3 months retrobulbar blood flowmeasurements of the ophthalmic artery (OA) and central retinal artery (CRA) were taken using colour Doppler imaging (CDI) ultrasound, concurrently with intraocular pressure (IOP). Results: Combigan® significantly reduced IOP after 3 months of treatment (P = 0.001), whereas placebo showed no significant change in IOP. The baseline haemodynamic parameters were similar between treatment and placebo groups. Patients treated with Combigan® showed a statistically significant decrease in CRA resistive index (P = 0.007). Conclusions: Patients treated for 3 months with Combigan® showed a significant decrease of CRA resistive index that could be explained by the decrease in IOP.
Bibliographic References
- Grieshaber, MC, Flammer, J. (2005). Blood flow in glaucoma. Curr Opin Ophthalmol.. 16. 79-83
- Gherghel, D, Hosking, SL, Orgul, S. (2004). Autonomic nervous system, circadian rhythms, and primary open-angle glaucoma. Surv Ophthalmol.. 49. 491-508
- Flammer, J. (1994). The vascular concept of glaucoma. Surv Ophthalmol.. 38. 3-6
- Flammer, J, Gasser, P, Prünte, CH, Yao, K.. (1992). Pharmacology of glaucoma. Williams & Wilkins. Baltimore.
- Emre, M, Orgül, S, Gugleta, K, Flammer, J. (2004). Ocular blood flow alteration in glaucoma is related to systemic vascular dysregulation. Br J Ophthalmol.. 88. 662
- Fuchsjäger-Mayrl, G, Wally, B, Georgopoulos, M, Rainer, G, Kircher, K, Buehl, W. (2004). Ocular blood flow and systemic blood pressure in patients with primary open-angle glaucoma and ocular hypertension. Invest Ophthalmol Vis Sci.. 45. 834
- Pache, M, Flammer, J. (2006). A sick eye in a sick body? Systemic findings in patients with primary open-angle glaucoma. Surv Ophthalmol.. 51. 179-212
- Hayreh, SS, Zimmerman, MB, Podhajsky, P, Alward, WL. (1994). Nocturnal arterial hypotension and its role in optic nerve head and ocular ischemic disorders. Am J Ophthalmol.. 117. 603
- Graham, SL, Drance, SM, Wijsman, K, Douglas, GR, Mikelberg, FS. (1995). Ambulatory blood pressure monitoring in glaucoma. The nocturnal dip. Ophthalmol.. 102. 61
- Polska, E, Polak, K, Luksch, A, Fuchsjager-Mayrl, G, Petternel, V, Findl, O. (2004). Twelve hour reproducibility of choroidal blood flow parameters in healthy subjects. Br J Ophthalmol.. 88. 533
- Matthiessen, ET, Zeitz, O, Richard, G, Klemm, M. (2004). Reproducibility of blood flow velocity measurements using colour decoded doppler imagin. Eye. (Lond).. 18. 400
- Quaranta, L, Harris, A, Donato, F, Cassamali, M, Semeraro, F. (1997). Color Doppler imagin of opthalmic artery blood flow velocity. Opthalmology.. 104. 653
- Hafez, AS, Bizzarro, RL, Rivard, M, Trabut, I, Lovasik, JV, Kergoat, H. (2003). Reproducibility of retinal and optic nerve head perfusion measurements using scanning laser Doppler flowmetry. Opthalmic Surg Lasers Imaging.. 34. 422
- Rankin, SJ, Walman, BE, Buckley, AR, Drance, SM. (1994). Color Doppler imaging and spectral analysis of the optic nerve vasculature in glaucoma. Am J Ophthalmol.. 119. 685
- Nicolela, MT, Walman, BE, Buckley, AR, Drance, SM. (1996). Ocular hypertension and primary open-angle glaucoma: a comparative study of their retrobulbar blood flow velocity. J Glaucoma.. 5. 308
- Harris, A, Williamson, TH, Martin, B, Shoemaker, JA, Sergott, RC, Spaeth, GL. (1995). Test/retest reproducibility of color Doppler imaging assessment of blood flow velocity in orbital vessels. J Glaucoma.. 4. 281
- Arici, MK, Sayici, M, Toker, M, Erdogan, H, Topalkara, A. (2002). A short term study of the additive effect of timolol and brimonidine on intraocular pressure. Eye (Lond).. 16. 39-43
- Lee, DA, Gornbein, JA. (2001). Effectiveness and safety of brimonidine as adjunctive therapy for patients with elevated intraocular pressure in a large, open-label community trial. J Glaucoma.. 10. 220
- Sherwood, MB, Craven, ER, Chou, C, DuBiner, HB, Batoosingh, AL, Schiffman, RM. (2006). Twice-daily 0.2% brimonidine-0.5% timolol fixed-combination therapy vs monotherapy with timolol or brimonidine in patients with glaucoma or ocular hypertension: a 12-month randomized trial. Arch Ophthalmol.. 124. 1230
- Steigerwalt, RD, Laurora, G, Belcaro, GV, Cesarone, MR, De Sanctis, MT, Incandela, L. (2001). Ocular and retrobulbar blood flow in ocular hypertensives treated with topical timolol, betaxolol and carteolol. J Ocul Pharmacol Ther.. 17. 537
- Steigerwalt, RD, Belcaro, G, Cesarone, MR, Laurora, G, De Sanctis, M, Incandela, L. (1995). Doppler ultrasonography of the central retinal artery in patients with diabetes and vascular disease treated with topical timolol. Eye (Lond).. 9. 495-501
- Steigerwalt, RD, Belcaro, G, Cesarone, MR, Laurora, G, De Sanctis, MT, Milazzo, M. (1993). Doppler ultrasonography of the central retinal artery in normals treated with topical timolol. Eye (Lond).. 7. 403
- Harris, A, Spaeth, GL, Sergott, RC, Katz, LJ, Cantor, LB, Martin, BJ. (1995). Retrobulbar arterial hemodynamic effects of betaxolol and timolol in normal-tension glaucoma. Am J Ophthalmol.. 120. 168
- Montanari, P, Marangoni, P, Oldani, A, Ratiglia, R, Raiteri, M, Berardinelli, L. (2001). Color Doppler imaging study in patients with primary open-angle glaucoma treated with timolol 0. 5% and carteolol 2%.. Eur J Ophthalmol.. 11. 240
- Lachkar, Y, Migdal, C, Dhanjil, S. (1998). Effect of brimonidine tartrate on ocular hemodynamic measurements. Arch Ophthalmol.. 116. 1591
- Inan, UU, Ermis, SS, Yücel, A, Öztürk, F. (2003). The effects of latanoprost and brimonidina on blood flow velocity of the retrobulbal vessels: a 3-month clinical trial. Acta Ophthalmol Scand.. 81. 155
- Simsek, T, Yanik, B, Conkbayir, I, Zilelioglu, O. (2006). Comparative analysis of the effects of brimonidine and dorzolamide on ocular blood flow velocity in patients with newly diagnosed primary open-angle glaucoma. J Ocul Pharmacol Ther.. 22. 79-85
- Jonescu-Cuypers, CP, Harris, A, Ishii, Y, Kagemann, L, Gazozi, HJ, Rotenstreich, Y. (2001). Effect of brimonidine tartrate on ocular hemodynamics in healthy volunteers. J Ocul Pharmacol Ther.. 17. 199-205
- Carlsson, AM, Chauhan, BC, Lee, AA, LeBlanc, RP. (2000). The effect of brimonidine tartrate on retinal blood flow in patients with ocular hypertension. Am J Ophthalmol.. 129. 297-301
- Bergstrand, IC, Heijl, A, Wollmer, P, Hansen, F, Harris, A. (2001). Timolol increased retrobulbar flow velocities in untreated glaucoma eyes but not in ocular hypertension. Acta Ophthalmol Scand.. 79. 455
- Harris, A, Joos, K, Kay, M, Evans, D, Shetty, R, Sponsel, WE. (1996). Acute IOP elevation with scleral suction: effects on retrobulbar haemodynamics. Br J Ophthalmol.. 80. 1055
- Stewart, WC, Stewart, JA, Day, D, Sharpe, ED. (2003). Efficacy and safety of timolol maleate/latanoprost fixed combination versus timolol maleate and brimonidine given twice daily. Acta Ophthalmol Scand.. 81. 242
- Stewart, WC, Stewart, JA, Jackson, AL. (2002). Cardiovascular effects of timolol maleate, brimonidine or brimonidine/timolol maleate in concomitant therapy. Acta Ophthalmol Scand.. 80. 277
- Waldock, A, Snape, J, Graham, CM. (2000). Effects of glaucoma medications on the cardiorespiratory and intraocular pressure status of newly diagnosed glaucoma patients. Br J Ophthalmol.. 84. 710
- Schuman, JS, Horwitz, B, Choplin, NT, David, R, Albracht, D, Chen, K.. (1997). A 1-year study of brimonidine twice daily in glaucoma and ocular hypertension: A controlled, randomized, multicenter clinical trial. Chronic Brimonidine Study Group. Arch Ophthalmol.. 115. 847
- Harris, A, Kagemann, L, Ehrlich, R, Rospigliosi, C, Moore, D, Siesky, B. (2008). Measuring and interpreting ocular blood flow and metabolism in glaucoma. Can J Ophthalmol.. 43. 328