Ocular blood flow and oxygen delivery to the retina in primary open-angle glaucoma patients

The addition of dorzolamide to timolol monotherapy

Brent Siesky, Alon Harris, Larry Kagemann, Einar Stefansson, Lynne McCranor, Brian Miller, Jeremiah Bwatwa, Guy Regev, Rita Ehrlich

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose: To assess the effects of adding dorzolamide to timolol monotherapy on ocular haemodynamics and retinal oxygen saturation in patients with primary open-angle glaucoma (POAG). Methods: Twenty-four patients (12 healthy, 12 with POAG) were treated with dorzolamide/timolol combination (DT) versus timolol maleate 0.5% twice daily in a randomized, crossover, double-blind study conducted over a period of 18 months. Patients received each treatment for 8 months then crossed over to the other treatment after a 1-month washout and second baseline. Goldmann applanation tonometry, Heidelberg retinal flowmetry (HRF), colour Doppler imaging (CDI) and retinal photographic oximetry were performed at each visit. Results: DT significantly reduced intraocular pressure (IOP) in both glaucomatous [right eye (OD) -13.15%, left eye (OS) -14.43%; p < 0.036] and non-glaucomatous (OD -12.4%, OS -13.88%; p < 0.039) patients compared to timolol after 8 months of treatment. DT significantly reduced the number of zero blood flow pixels in the superior (-39.72%; p < 0.014) and inferior (-51.44%; p < 0.008) retina in the non-glaucomatous group and inferior retina in the glaucomatous group (-55.38%, p < 0.006). The continuation of timolol monotherapy from baseline did not change (p < 0.05) any measured parameter and neither treatment had a significant effect (p < 0.05) on retinal oximetry or CDI parameters. Conclusion: The addition of dorzolamide to timolol monotherapy decreases IOP and increases retinal blood flow in the superficial retinal vasculature in both glaucomatous and healthy patients following 8 months of treatment. The combination of increased retinal blood flow with consistent oxygen saturation may potentially increase oxygen delivery to the retina.

Original languageEnglish
Pages (from-to)142-149
Number of pages8
JournalActa Ophthalmologica
Volume88
Issue number1
DOIs
StatePublished - Feb 2010

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dorzolamide
Timolol
Retina
Oxygen
Oximetry
Intraocular Pressure
Color
Therapeutics
Rheology
Manometry
Double-Blind Method
Hemodynamics
Primary Open Angle Glaucoma

Keywords

  • Dorzolamide
  • Glaucoma
  • Ocular blood flow
  • Oximetry
  • Timolol maleate

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Ocular blood flow and oxygen delivery to the retina in primary open-angle glaucoma patients : The addition of dorzolamide to timolol monotherapy. / Siesky, Brent; Harris, Alon; Kagemann, Larry; Stefansson, Einar; McCranor, Lynne; Miller, Brian; Bwatwa, Jeremiah; Regev, Guy; Ehrlich, Rita.

In: Acta Ophthalmologica, Vol. 88, No. 1, 02.2010, p. 142-149.

Research output: Contribution to journalArticle

Siesky, Brent ; Harris, Alon ; Kagemann, Larry ; Stefansson, Einar ; McCranor, Lynne ; Miller, Brian ; Bwatwa, Jeremiah ; Regev, Guy ; Ehrlich, Rita. / Ocular blood flow and oxygen delivery to the retina in primary open-angle glaucoma patients : The addition of dorzolamide to timolol monotherapy. In: Acta Ophthalmologica. 2010 ; Vol. 88, No. 1. pp. 142-149.
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abstract = "Purpose: To assess the effects of adding dorzolamide to timolol monotherapy on ocular haemodynamics and retinal oxygen saturation in patients with primary open-angle glaucoma (POAG). Methods: Twenty-four patients (12 healthy, 12 with POAG) were treated with dorzolamide/timolol combination (DT) versus timolol maleate 0.5{\%} twice daily in a randomized, crossover, double-blind study conducted over a period of 18 months. Patients received each treatment for 8 months then crossed over to the other treatment after a 1-month washout and second baseline. Goldmann applanation tonometry, Heidelberg retinal flowmetry (HRF), colour Doppler imaging (CDI) and retinal photographic oximetry were performed at each visit. Results: DT significantly reduced intraocular pressure (IOP) in both glaucomatous [right eye (OD) -13.15{\%}, left eye (OS) -14.43{\%}; p < 0.036] and non-glaucomatous (OD -12.4{\%}, OS -13.88{\%}; p < 0.039) patients compared to timolol after 8 months of treatment. DT significantly reduced the number of zero blood flow pixels in the superior (-39.72{\%}; p < 0.014) and inferior (-51.44{\%}; p < 0.008) retina in the non-glaucomatous group and inferior retina in the glaucomatous group (-55.38{\%}, p < 0.006). The continuation of timolol monotherapy from baseline did not change (p < 0.05) any measured parameter and neither treatment had a significant effect (p < 0.05) on retinal oximetry or CDI parameters. Conclusion: The addition of dorzolamide to timolol monotherapy decreases IOP and increases retinal blood flow in the superficial retinal vasculature in both glaucomatous and healthy patients following 8 months of treatment. The combination of increased retinal blood flow with consistent oxygen saturation may potentially increase oxygen delivery to the retina.",
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AB - Purpose: To assess the effects of adding dorzolamide to timolol monotherapy on ocular haemodynamics and retinal oxygen saturation in patients with primary open-angle glaucoma (POAG). Methods: Twenty-four patients (12 healthy, 12 with POAG) were treated with dorzolamide/timolol combination (DT) versus timolol maleate 0.5% twice daily in a randomized, crossover, double-blind study conducted over a period of 18 months. Patients received each treatment for 8 months then crossed over to the other treatment after a 1-month washout and second baseline. Goldmann applanation tonometry, Heidelberg retinal flowmetry (HRF), colour Doppler imaging (CDI) and retinal photographic oximetry were performed at each visit. Results: DT significantly reduced intraocular pressure (IOP) in both glaucomatous [right eye (OD) -13.15%, left eye (OS) -14.43%; p < 0.036] and non-glaucomatous (OD -12.4%, OS -13.88%; p < 0.039) patients compared to timolol after 8 months of treatment. DT significantly reduced the number of zero blood flow pixels in the superior (-39.72%; p < 0.014) and inferior (-51.44%; p < 0.008) retina in the non-glaucomatous group and inferior retina in the glaucomatous group (-55.38%, p < 0.006). The continuation of timolol monotherapy from baseline did not change (p < 0.05) any measured parameter and neither treatment had a significant effect (p < 0.05) on retinal oximetry or CDI parameters. Conclusion: The addition of dorzolamide to timolol monotherapy decreases IOP and increases retinal blood flow in the superficial retinal vasculature in both glaucomatous and healthy patients following 8 months of treatment. The combination of increased retinal blood flow with consistent oxygen saturation may potentially increase oxygen delivery to the retina.

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