Tamaki Y, Nagahara M, Araie M, Tomita K, Sandoh S, Tomidokoro A
Department of Ophthalmology, University of Tokyo School of Medicine, Japan.
J Ocul Pharmacol Ther. 2001 Oct;17(5):403-11. doi: 10.1089/108076801753266785.
The purpose of the present study was to study the effect of a single instillation of latanoprost on the human optic nerve head (ONH) and retinal circulation. Using laser-speckle tissue blood flow analysis, normalized blur (NB; a quantitative index of tissue blood velocity) was measured every 0.125 sec at a temporal ONH site free of visible surface vessels. Measurements were averaged for 3 cardiac cycles (NB(ONH)). Color Doppler Imaging (CDI) was also used to evaluate peak systolic blood velocity (PSV), endo-diastolic velocity (EDV), and resistive index (RI) in the central retinal artery (CRA) and mean blood velocity (MV) in the central retinal vein (CRV). One drop of 0.005% latanoprost was instilled into one eye and its vehicle into the other in eleven healthy volunteers in a double-blinded manner. Measurements of bilateral NB(ONH), CDI parameters, intraocular pressure (IOP), blood pressure (BP), and pulse rate (PR) were performed before, and 45, 90, 180, and 270 min after instillation. After a single instillation of latanoprost or the vehicle, there was no significant bilateral difference throughout the experimental period. The difference in NB(ONH) between that before and at each time point of measurement (delta NB(ONH)) in the latanoprost-treated eyes was significantly higher between 45 and 270 min after instillation than that in vehicle-treated eyes (P = 0.0003 to 0.0156); ANOVA for repeated measurements also revealed significant difference between both eyes (P < 0.00001). BP, PR, and NB(ONH) in the eye that received only the vehicle, PSV, EDV, and RI in the CRA in both eyes, and MV in the CRV in both eyes changed little. Tissue blood velocity in the ONH increased at least temporarily following a single instillation of topical latanoprost. Although the mechanism of the increase is unclear, the effects of latanoprost on ONH tissue circulation in humans may have clinical implications.
本研究的目的是探讨单次滴注拉坦前列素对人视神经乳头(ONH)和视网膜循环的影响。使用激光散斑组织血流分析,在颞侧ONH无可见表面血管的部位,每0.125秒测量一次归一化模糊度(NB;组织血流速度的定量指标)。测量值取3个心动周期的平均值(NB(ONH))。彩色多普勒成像(CDI)也用于评估视网膜中央动脉(CRA)的收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)和阻力指数(RI)以及视网膜中央静脉(CRV)的平均血流速度(MV)。11名健康志愿者以双盲方式,一只眼滴注一滴0.005%的拉坦前列素,另一只眼滴注其赋形剂。在滴注前以及滴注后45、90、180和270分钟测量双侧NB(ONH)、CDI参数、眼压(IOP)、血压(BP)和脉搏率(PR)。单次滴注拉坦前列素或其赋形剂后,在整个实验期间双侧均无显著差异。拉坦前列素治疗组眼中,滴注后45至270分钟内,各测量时间点与滴注前的NB(ONH)差值(δNB(ONH))显著高于赋形剂治疗组(P = 0.0003至0.0156);重复测量的方差分析也显示双眼之间存在显著差异(P < 0.00001)。仅接受赋形剂的眼的BP、PR和NB(ONH),双眼CRA的PSV、EDV和RI,以及双眼CRV的MV变化很小。单次局部滴注拉坦前列素后,ONH的组织血流速度至少会暂时增加。虽然增加的机制尚不清楚,但拉坦前列素对人ONH组织循环的影响可能具有临床意义。