Abstract
Purpose: :
To evaluate visual outcomes with dorzolamide compared to non–active blood flow agents in primary open–angle glaucoma.
Methods: :
Records were reviewed from primary open–angle glaucoma patients who had been treated with an agent that potentially improves ocular blood flow (i.e., dorzolamide) compared to non–active blood flow agents (control group) including non–selective ß–blockers, prostaglandins and miotics over five years. The groups were matched by intraocular pressure, cardiovascular history and age. Progression was determined by the clinician and was based on worsened optic disc and/or visual field findings.
Results: :
Data was collected from 250 patients that provided 50 matched pairs for the dorzolamide and control group. In the dorzolamide group two (4%) patients progressed and in the control group seven (14%) patients progressed over five years (P = 0.09). Both progressed patients in the dorzolamide group had mean intraocular pressures of 13 mm Hg and the control group had mean intraocular pressures of 15–20 mm Hg. The mean follow–up time for the progressed patients in the control group was 26.4 ± 17.5 months and 38.9 ± 14.9 months in the dorzolamide group (P = 0.43).
Conclusions: :
This pilot trial demonstrated a trend towards less glaucomatous progression in patients treated with an assumed active blood flow product. In addition, progression was delayed and occurred at lower pressures in the active blood flow group. This pilot trial suggests that future prospective, long–term, visual outcomes studies in patients treated with a medicine with a positive ocular blood flow effect may be warranted.
Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • intraocular pressure