Abstract
Abstract: :
Purpose: To examine peripapillary capillary blood flow with Scanning Laser Doppler Flowmetry (SLDF) using the Heidelberg Retinal Flowmeter in glaucoma patients on timolol alone, fixed combination timolol–dorzolamide, and timolol plus latanoprost. Methods: We prospectively evaluated patients with mild primary open–angle, normal–tension, and pseudoexfoliative glaucoma. Age, race, gender, diagnosis, blood pressure, pulse, and visual acuity were recorded. Intraocular pressure was recorded at 2–hour intervals over an 8–hour period. Patients were then evaluated on 4 visits by an examiner masked to treatment. Each treatment period comprised a minimum of 4 weeks. For visits 1 and 3, all patients received timolol alone. Patients were randomized to two groups: Group A received fixed combination timolol–dorzolamide for visit 2 and timolol plus latanoprost for visit 4; Group B received the same medications in the opposite order. On each visit, superotemporal and inferotemporal peripapillary capillary flow were measured by SLDF and evaluated by the Automatic Full Field Perfusion Image Analyzer. Visual acuity, intraocular pressure, blood pressure, pulse, time of day, and adverse effects of treatment were recorded for each visit. Results: Fifty eyes of 31 patients were enrolled. For Group A, mean temporal capillary blood flow was 411 + 126 units at visit 1; 392 + 86 units at visit 2; 385 + 62 units at visit 3; and 417 + 118 units at visit 4. For Group B, temporal capillary flow was 436 + 133 units at visit 1; 419 + 78 units at visit 2; 393 + 85 units at visit 3; and 403 + 91 units at visit 4. Differences in flow at each visit for each group were not statistically significant. With respect to each treatment, there were no statistically significant differences in flow when combining data from both groups or when separating superotemporal and inferotemporal flow. Conclusions: In patients with mild glaucoma on timolol alone, treatment with fixed combination timolol–dorzolamide and timolol plus latanoprost had no statistically significant effect on temporal peripapillary capillary flow measured by SLDF. The absence of an observed effect does not preclude changes in flow at other anatomic locations or changes detected by other methods.
Keywords: optic flow • imaging/image analysis: clinical