The acute effect of topical beta-adrenoreceptor blocking agents on retinal and optic nerve head circulation

Oliver Arend, Alon Harris, Susanne Arend, Andreas Remky, B. J. Martin

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Purpose: Topical beta-blockers are the most common treatment for ocular hypertension in glaucoma, but their ocular hemodynamic effects are not well known. We investigated the acute effects of betaxolol (β-1 selective antagonist), levobunolol (non-selective antagonist with active polar metabolite), and timolol (non-selective antagonist) on retinal and superficial optic nerve head circulation. Methods: Intraocular pressure (IOP), heart rate, blood pressure, and retinal circulation were evaluated in 12 healthy subjects (6F/6M; mean age = 24 ± 2 years) before and two hours after instillation of each drug on separate occasions at least two weeks apart. Macular capillary blood velocity (MCBV), epipapillary blood velocities (EBV), arteriovenous passage (AVP) times, and arterial and venous diameters were measured by digital image analysis of scanning laser fluorescein angiograms. Results: All drugs significantly (p < 0.05) reduced IOP. There was no significant effect on blood pressure or calculated ocular perfusion pressure. Only levobunolol significantly lowered heart rate (p < 0.05). Each drug produced a significant (p < 0.01) decrease in AVP time of approximately 25%. MCBV was significantly (p < 0.01) increased by approximately 20% in all three conditions; each drug also produced significant (p < 0.01) increases in EBV. Arterial and venous diameters remained unaffected. Conclusion: All three drugs, despite different beta-adrenergic properties, increased blood velocities in retinal and epipapillary capillaries. These changes, occurring as they do in concert with decreased retinal arteriovenous passage time at constant retinal arterial and venous diameter, may indicate improved retinal perfusion after drug treatment. Improved circulation, if it indeed occurs, in tandem with reduced IOP, might explain in part the beneficial effect of β-adrenoreceptor blocking agents in glaucomatous patients.

Original languageEnglish
Pages (from-to)43-49
Number of pages7
JournalActa Ophthalmologica Scandinavica
Volume76
Issue number1
StatePublished - 1998

Fingerprint

Optic Disk
Levobunolol
Intraocular Pressure
Pharmaceutical Preparations
Drug Instillation
Perfusion
Heart Rate
Betaxolol
Blood Pressure
Timolol
Ocular Hypertension
Fluorescein
Glaucoma
Adrenergic Agents
Healthy Volunteers
Angiography
Lasers
Hemodynamics
Pressure
Therapeutics

Keywords

  • Angiography
  • Beta blocking agents
  • Retinal circulation

ASJC Scopus subject areas

  • Ophthalmology

Cite this

The acute effect of topical beta-adrenoreceptor blocking agents on retinal and optic nerve head circulation. / Arend, Oliver; Harris, Alon; Arend, Susanne; Remky, Andreas; Martin, B. J.

In: Acta Ophthalmologica Scandinavica, Vol. 76, No. 1, 1998, p. 43-49.

Research output: Contribution to journalArticle

Arend, Oliver ; Harris, Alon ; Arend, Susanne ; Remky, Andreas ; Martin, B. J. / The acute effect of topical beta-adrenoreceptor blocking agents on retinal and optic nerve head circulation. In: Acta Ophthalmologica Scandinavica. 1998 ; Vol. 76, No. 1. pp. 43-49.
@article{7c812715a47646a0a91b0ab4598078f4,
title = "The acute effect of topical beta-adrenoreceptor blocking agents on retinal and optic nerve head circulation",
abstract = "Purpose: Topical beta-blockers are the most common treatment for ocular hypertension in glaucoma, but their ocular hemodynamic effects are not well known. We investigated the acute effects of betaxolol (β-1 selective antagonist), levobunolol (non-selective antagonist with active polar metabolite), and timolol (non-selective antagonist) on retinal and superficial optic nerve head circulation. Methods: Intraocular pressure (IOP), heart rate, blood pressure, and retinal circulation were evaluated in 12 healthy subjects (6F/6M; mean age = 24 ± 2 years) before and two hours after instillation of each drug on separate occasions at least two weeks apart. Macular capillary blood velocity (MCBV), epipapillary blood velocities (EBV), arteriovenous passage (AVP) times, and arterial and venous diameters were measured by digital image analysis of scanning laser fluorescein angiograms. Results: All drugs significantly (p < 0.05) reduced IOP. There was no significant effect on blood pressure or calculated ocular perfusion pressure. Only levobunolol significantly lowered heart rate (p < 0.05). Each drug produced a significant (p < 0.01) decrease in AVP time of approximately 25{\%}. MCBV was significantly (p < 0.01) increased by approximately 20{\%} in all three conditions; each drug also produced significant (p < 0.01) increases in EBV. Arterial and venous diameters remained unaffected. Conclusion: All three drugs, despite different beta-adrenergic properties, increased blood velocities in retinal and epipapillary capillaries. These changes, occurring as they do in concert with decreased retinal arteriovenous passage time at constant retinal arterial and venous diameter, may indicate improved retinal perfusion after drug treatment. Improved circulation, if it indeed occurs, in tandem with reduced IOP, might explain in part the beneficial effect of β-adrenoreceptor blocking agents in glaucomatous patients.",
keywords = "Angiography, Beta blocking agents, Retinal circulation",
author = "Oliver Arend and Alon Harris and Susanne Arend and Andreas Remky and Martin, {B. J.}",
year = "1998",
language = "English",
volume = "76",
pages = "43--49",
journal = "Acta Ophthalmologica",
issn = "1755-375X",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - The acute effect of topical beta-adrenoreceptor blocking agents on retinal and optic nerve head circulation

AU - Arend, Oliver

AU - Harris, Alon

AU - Arend, Susanne

AU - Remky, Andreas

AU - Martin, B. J.

PY - 1998

Y1 - 1998

N2 - Purpose: Topical beta-blockers are the most common treatment for ocular hypertension in glaucoma, but their ocular hemodynamic effects are not well known. We investigated the acute effects of betaxolol (β-1 selective antagonist), levobunolol (non-selective antagonist with active polar metabolite), and timolol (non-selective antagonist) on retinal and superficial optic nerve head circulation. Methods: Intraocular pressure (IOP), heart rate, blood pressure, and retinal circulation were evaluated in 12 healthy subjects (6F/6M; mean age = 24 ± 2 years) before and two hours after instillation of each drug on separate occasions at least two weeks apart. Macular capillary blood velocity (MCBV), epipapillary blood velocities (EBV), arteriovenous passage (AVP) times, and arterial and venous diameters were measured by digital image analysis of scanning laser fluorescein angiograms. Results: All drugs significantly (p < 0.05) reduced IOP. There was no significant effect on blood pressure or calculated ocular perfusion pressure. Only levobunolol significantly lowered heart rate (p < 0.05). Each drug produced a significant (p < 0.01) decrease in AVP time of approximately 25%. MCBV was significantly (p < 0.01) increased by approximately 20% in all three conditions; each drug also produced significant (p < 0.01) increases in EBV. Arterial and venous diameters remained unaffected. Conclusion: All three drugs, despite different beta-adrenergic properties, increased blood velocities in retinal and epipapillary capillaries. These changes, occurring as they do in concert with decreased retinal arteriovenous passage time at constant retinal arterial and venous diameter, may indicate improved retinal perfusion after drug treatment. Improved circulation, if it indeed occurs, in tandem with reduced IOP, might explain in part the beneficial effect of β-adrenoreceptor blocking agents in glaucomatous patients.

AB - Purpose: Topical beta-blockers are the most common treatment for ocular hypertension in glaucoma, but their ocular hemodynamic effects are not well known. We investigated the acute effects of betaxolol (β-1 selective antagonist), levobunolol (non-selective antagonist with active polar metabolite), and timolol (non-selective antagonist) on retinal and superficial optic nerve head circulation. Methods: Intraocular pressure (IOP), heart rate, blood pressure, and retinal circulation were evaluated in 12 healthy subjects (6F/6M; mean age = 24 ± 2 years) before and two hours after instillation of each drug on separate occasions at least two weeks apart. Macular capillary blood velocity (MCBV), epipapillary blood velocities (EBV), arteriovenous passage (AVP) times, and arterial and venous diameters were measured by digital image analysis of scanning laser fluorescein angiograms. Results: All drugs significantly (p < 0.05) reduced IOP. There was no significant effect on blood pressure or calculated ocular perfusion pressure. Only levobunolol significantly lowered heart rate (p < 0.05). Each drug produced a significant (p < 0.01) decrease in AVP time of approximately 25%. MCBV was significantly (p < 0.01) increased by approximately 20% in all three conditions; each drug also produced significant (p < 0.01) increases in EBV. Arterial and venous diameters remained unaffected. Conclusion: All three drugs, despite different beta-adrenergic properties, increased blood velocities in retinal and epipapillary capillaries. These changes, occurring as they do in concert with decreased retinal arteriovenous passage time at constant retinal arterial and venous diameter, may indicate improved retinal perfusion after drug treatment. Improved circulation, if it indeed occurs, in tandem with reduced IOP, might explain in part the beneficial effect of β-adrenoreceptor blocking agents in glaucomatous patients.

KW - Angiography

KW - Beta blocking agents

KW - Retinal circulation

UR - http://www.scopus.com/inward/record.url?scp=0031911592&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031911592&partnerID=8YFLogxK

M3 - Article

VL - 76

SP - 43

EP - 49

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

SN - 1755-375X

IS - 1

ER -