Abstract
Abstract: :
Purpose:The objective of this study is to determine the effect of topical dorzolamide 2% on capillary blood flow in patients with normal tension glaucoma (NTG) Methods:13 patients with NTG, without prior treatment, underwent baseline HRF studies taken at the neuroretinal rim (RIM), superotemporal (ST), inferotemporal (IT), and nasal juxtapapillary (Nasal) regions. Patients were started on dorzolamide 2% tid and HRF studies were repeated at 2 weeks, 4 weeks, and following a 4 week washout period. Images were analyzed using the SLDF-AFFPIA software. Changes in flow from baseline were analyzed as a group, and divided into two subgroups; patients with baseline blood flows less than 300 au (low-flow group), and patients with baseline flows ≥ 300 au (normal flow group). Results:Mean IOP decreased from 15.1 mm Hg to 13.7 mm Hg (p=.05) at 2 weeks, and 13.6 mm Hg (p=.01) at 4 weeks with treatment, and increased to 14.7 mm Hg (p=.68) after washout. For the entire group, blood flow increased only in the ST region (18.3%, p=.04) at 4 weeks. The Low flow NTG group (n=5) showed statistically significant increases in blood flow at 4 weeks of: ST - 40% (p=0.02); IT - 24% (p=0.02); RIM - 23% (p=0.01); and Nasal - 42% (p=0.03). However, normal flow NTG patients (n=8) showed no significant change in blood flow in any of the measured regions at any time point. Following washout, there was no significant change in blood flow from baseline. Conclusion:A subclass of normal tension glaucoma patients with low blood flow by HRF, responds to dorzolamide with significantly increased capillary blood flow.
Keywords: 499 optic flow • 331 blood supply • 432 imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)