Martinez A, Gonzalez F, Capeans C, Perez R, Sanchez-Salorio M
Instituto Galego de Oftalmoloxia, Facultad de Medicina, Complejo Hospitalario Universitario de Santiago, Universidad de Santiago, Spain.
Invest Ophthalmol Vis Sci. 1999 May;40(6):1270-5.
To evaluate the effect of dorzolamide on ocular blood flow in normal and glaucomatous eyes.
Twenty-six eyes with documented open-angle glaucoma of 26 patients and 13 normal control eyes of 8 age-matched subjects were included in this study. All eyes underwent color Doppler imaging for measuring peak-systolic velocity, end-diastolic velocity, and resistance index in the ophthalmic and central retinal arteries and the maximal and minimal velocities in the central retinal vein. Eyes were grouped in control and initial and advanced glaucoma categories. Measurements were made in all groups before and after application of topical dorzolamide. Intragroup comparisons between baseline and dorzolamide conditions were made using paired Student's t-test. Intergroup comparisons under baseline conditions between normal and glaucomatous eyes were made by using the one-way ANOVA test. Statistical significance was set at P < 0.05.
The peak-systolic velocity of the central retinal artery in glaucomatous eyes and the end-diastolic velocity of the ophthalmic and central retinal arteries in all groups were significantly higher after application of dorzolamide. The minimal velocity of the central retinal vein showed significantly higher values after dorzolamide, whereas the maximal velocity remained unchanged. The peak-systolic velocity of the ophthalmic artery in all groups and the peak-systolic velocity of the central retinal artery in normal eyes also remained unchanged. The resistance index was significantly lower in the ophthalmic and central retinal arteries in all groups after dorzolamide. The intraocular pressure was significantly reduced in all groups after dorzolamide. Under baseline conditions normal control eyes and glaucomatous eyes showed differences in various measurements. Peak-systolic velocity was significantly lower in glaucomatous eyes than in normal control eyes with the exception of the ophthalmic artery in the initial glaucoma group. End-diastolic velocity was lower in glaucomatous eyes than in control eyes in both arteries. Maximal and minimal velocities of the central retinal vein were lower in glaucomatous eyes than in normal control eyes. Resistance index was higher in glaucomatous eyes than in normal control eyes in the ophthalmic artery but not in the central retinal artery.
Most hemodynamic parameters of intraocular and periocular vessels improve after application of topical dorzolamide in both normal control and glaucomatous eyes. Dorzolamide should be regarded as a useful drug for treatment of glaucoma not only because it reduces intraocular pressure but also because it improves the ocular blood supply.
评估多佐胺对正常眼和青光眼患者眼血流的影响。
本研究纳入了26例患者的26只记录有开角型青光眼的眼睛以及8例年龄匹配受试者的13只正常对照眼。所有眼睛均接受彩色多普勒成像,以测量眼动脉和视网膜中央动脉的收缩期峰值速度、舒张末期速度和阻力指数,以及视网膜中央静脉的最大和最小速度。眼睛被分为对照组、早期青光眼组和晚期青光眼组。在局部应用多佐胺之前和之后对所有组进行测量。使用配对学生t检验对基线和多佐胺用药后的组内进行比较。在基线条件下,使用单因素方差分析对正常眼和青光眼眼之间进行组间比较。设定统计学显著性为P < 0.05。
应用多佐胺后,青光眼眼中视网膜中央动脉的收缩期峰值速度以及所有组中眼动脉和视网膜中央动脉的舒张末期速度均显著升高。视网膜中央静脉的最小速度在应用多佐胺后显著升高,而最大速度保持不变。所有组中眼动脉的收缩期峰值速度以及正常眼中视网膜中央动脉的收缩期峰值速度也保持不变。应用多佐胺后,所有组中眼动脉和视网膜中央动脉的阻力指数均显著降低。应用多佐胺后所有组的眼压均显著降低。在基线条件下,正常对照眼和青光眼眼在各项测量中存在差异。除早期青光眼组的眼动脉外,青光眼眼中视网膜中央动脉的收缩期峰值速度显著低于正常对照眼。在两条动脉中,青光眼眼中的舒张末期速度均低于对照眼。青光眼眼中视网膜中央静脉的最大和最小速度均低于正常对照眼。青光眼眼中眼动脉的阻力指数高于正常对照眼,但视网膜中央动脉中并非如此。
在正常对照眼和青光眼眼中,局部应用多佐胺后眼内和眼周血管的大多数血流动力学参数均得到改善。多佐胺不仅因其降低眼压,还因其改善眼供血,应被视为治疗青光眼的一种有用药物。