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K.G. Schmidt, V. Klingmüller, A.G. Böhm, N.N. Osborne, L.E. Pillunat; Perioptic Short Posterior Ciliary Artery and Central Retinal Artery Hemodynamics in Primary Open Angle Glaucoma Patients on Brimonidine . Invest. Ophthalmol. Vis. Sci. 2003;44(13):356.
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Purpose: Peripapillary hemodynamics is increasingly being discussed in the prognosis of primary open angle glaucoma (PAOG). Current antiglaucomatous drugs - in addition to reducing intraocular pressure (IOP) - should not impair perfusion to the optic nerve head, the area of primary damage in this progressive optic neuropathy. This study was designed to evaluate the influence of brimonidine, a potentially vasoconstrictive alpha-2-receptor agonist, on perioptic short posterior ciliary artery (PSPCA) and central retinal artery (CRA) vascular systems in POAG patients. Methods: The influence of brimonidine (0.2%), in standard dosage (BID, 1 eye) on PSPCA and CRA hemodynamics (9 MHz linear and phased array scanners, Elegra Advanced System, Siemens, Germany, transmission energy reduced to 40%, B-, C-, & triplex-modes), IOP, and systemic perfusion parameters was investigated in 17 POAG patients without clinically relevant extracranial stenosis (< 50% reduction in vessel diameter) as excluded by sonography of common, external and internal carotid arteries. Measurements were taken before and following 4 weeks of brimonidine therapy. Results (mean ± SD): Following application of brimonidine IOP (mmHg) in drug treated POAG eyes was significantly (sig., p< 0.0001) reduced from 26.4 ± 1.3 to 21.5 ± 1.6. When compared to pretreatment values PSPCA and CRA perfusion parameters (peak systolic velocity, enddiastolic velocity, pulsatility and resistance indexes and systemic perfusion parameters were not sig. (p> 0.05) altered following application of brimonidine. Conclusions: Brimonidine reduced IOP by 18.7%, a negative hemodynamic effect on vessels feeding the optic nerve head, the area of primary damage in POAG, was excluded by this study.
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