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Denise Descovich, Paul Harasymowycz, Mark R. Lesk; Change in Diurnal Fluctuation of Pulsatile Ocular Parameters in the DIOXXACT Study (Diurnal IOP and OBF Xalatan vs. Xalatan And Cosopt Trial). Invest. Ophthalmol. Vis. Sci. 2011;52(14):3488.
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Diurnal fluctuations in IOP are strongly associated with progression of open angle glaucoma. Our goal was to monitor diurnal fluctuations in IOP and choroidal blood flow when Cosopt was added to patients under Xalatan monotherapy.
Measurements were performed on 17 open angle glaucoma patients on Xalatan monotherapy. All patients have undergone a complete diurnal workup at 8am, 10am, 2pm, and 4pm including IOP and Pulse amplitude (OPA) measured with the Pascal Dynamic Contour Tonometer and Choroidal blood flow measured in the sub-foveolar choroid using single-point laser Doppler flowmetry (Oculix). The pulsatility of VEL, VOL and FLO was determined with automated software using for example, the formula (systolic VEL- diastolic VEL) / systolic VEL. Cosopt has been added and the same measures were repeated 6 weeks later.
After the addition of Cosopt, mean IOP measured with the Pascal showed a significant reduction (from 18.14 ± 3.5 to 15.52 ± 2.1mmHg) (p<0.01) as well as the mean OPA (2.64 ± 0.8 to 2.24 ± 0.9mmHg) (p<0.01). The mean pulsatility of volume at the choroid has decreased with the addition of Cosopt, but not significantly (from 0.433 ± 0.187 to 0.365 ± 0.121).
Adding Cosopt to patients on Xalatan monotherapy has reduced significantly the IOP and Pulsatility. However, pulsatile choroidal flowmetry measurements were not significantly reduced in this sample.
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