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L Kobayashi, K Mori, T Ishibashi, S Naruse, S Kinoshita; Effects of Kallidinogenase on Retinal Blood Flow in Normal Subjects and Glaucoma Patients . Invest. Ophthalmol. Vis. Sci. 2002;43(13):324.
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Purpose:Kallidinogenase is a proteinase processing kininogens to release bioactive kinins. Kinins has a vasodilating effect on arteriole and capillaries, but its effect on retinal blood flow has not reported yet. We investigate the effect of oral kallidinogenase treatment on retinal blood flow in normal subjects and glaucoma patients. Methods: This prospective study examined the effects of 4-week treatment with oral kallidinogenase 150 IU/day. Retinal blood flow in 6 eyes of 6 normal subjects and 6 eyes of 6 glaucoma patients (4 NTG and 2 POAG patients) was measured with confocal scanning laser Doppler flowmetry (Heidelberg Retina Flowmeter, HRF, Heidelberg Engineering Heidelberg, Germany) before and after 4-week treatment. All subjects in both groups has visual acuity equal to or better than 20/40. Exclusion criteria in normal subjects were any systemic disease, history of ocular disease and high ocular pressure more than 21mmHg. If both eyes of the subject met the enrollment criteria, right eye was selected for this study. Ocular hypotensive medications were used throughout the study period, if patients used. HRF measurement area was determined at approximately a half-disc diameter distance temporally from the edge of the optic disc. We obtained three images, and measured retinal blood flow within five 1010 pixel windows in each image. Totally 15 measurement values were averaged and used for the further analysis. Results: Retinal blood flow was significantly increased in both normal and glaucoma patients after 4-week treatment (p<0.05; paired t-test), increasing from 230.936.7 to 276.249.2 in normal subjects and from 222.632.2 to 268.467.8 in glaucoma patients. Intraocular pressure did not change after 4-week treatment. Conclusion: Kallidinogenase increases retinal blood flow in both normal subjects and glaucoma patients. Kallidinogenase might be effective on some patients with vascular factor related NTG.
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