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P.C. Galambos, N. Matthiesen, L. Wagenfeld, A. Wiermann, R. Praga, E.T. Matthiessen, G. Richard, M. Klemm, O. Zeitz; Systemic Betablocker Treatment With Nebivolol Enhances Ocular Hemodynamics in Glaucoma Patients With Arterial Hypertension . Invest. Ophthalmol. Vis. Sci. 2006;47(13):485.
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Treatment of arterial hypertension potentially leads to a reduction of ocular blood flow by lowering perfusion pressure. Aim of the present study was to investigate the effect of nebivolol, a systemic beta–blocker with NO–releasing and vasodilatory qualities, on the blood flow velocities in the retrobulbar vasculature.
Peak systolic velocity (PSV) and end–diastolic velocity (EDV) in the short and long posterior ciliary artery (SPCA, LPCA), central retinal artery (CRA) and ophthalmic artery (OA) were recorded by color Doppler imaging (CDI) in 13 glaucoma patients with arterial hypertension before and 4 weeks after a switch of systemic antihypertensive betablocker medication to nebivolol.
Four weeks after a switch to nebivolol therapy CDI measurements revealed a significant acceleration of the PSV (8.9±0.7cms–1 vs 11.5±0.9cms–1; P=0.023) and EDV (1.9±0.1cms–1 vs 2.4±0.2cms–1; P=0.048) in the SPCA and PSV (13.2±1.3cms–1 vs 16.1±1.1cms–1; P=0.027) of the LPCA. EDV of LPCA (2.5±0.3cms–1 vs 3.2±0.4cms–1; P=0.072) was noticeably but statistically non–significantly increased. No significant differences in flow velocities were found for the CRA and OA. IOP and systemic blood pressure remained unchanged.
Blood pressure treatment with nebivolol leads to an acceleration of perfusion in the vessels crucial for the blood supply to the optic nerve head. The present data are the basis for a double–blinded and randomized trial conducted at our eye clinic in order to investigate beneficial effects of nebivolol in glaucoma patients and evaluate whether nebivolol should be a preferred systemic antihypertensive beta–blocker treatment in glaucoma patients suffering from arterial hypertension.
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