Sato T, Muto T, Ishibashi Y, Roy S
Department of Ophthalmology, Boston University School of Medicine, Massachusetts 02118, USA.
Curr Eye Res. 2001 Oct;23(4):298-306. doi: 10.1076/ceyr.23.4.298.5448.
In this study the acute effect of the topically-delivered non-selective beta-blockers timolol and carteolol, and the selective beta-blocker betaxolol, were evaluated with respect to ocular blood flow, intraocular pressure (IOP) and vessel resistance in rabbits' eyes.
In a double masked randomized design, one eye of each subject (n = 9) received two drops of 0.5 % timolol or 2 % cartelol or 0.5 % betaxolol ophthalmic solution and a separate group of nine rabbits received two drops of placebo consisting of physiological saline in both eyes to serve as control. Using hydrogen clearance method, ciliary body blood flow (CiBF), choroidal blood flow (CBF), and retinal blood flow (RBF) were measured. IOP and systemic mean arterial pressure (MAP) of each subject were measured under same condition before and after the administration of respective drugs to calculate the ocular perfusion pressure (OPP) and vessel resistance.
In timolol- and carteolol-treated eyes significant reduction was observed in IOP (p < 0.01), CiBF (p < 0.01), CBF (p < 0.01) and RBF (p < 0.01) compared to control eyes. However, in betaxolol-treated eyes a marginal reduction in IOP was observed accompanied by significant increase in CiBF (p < 0.01) and RBF (p < 0.05). The non-selective beta-blocker-treated eyes tended to have increased vessel resistance, whereas, selective beta-blocker-treated eyes tended to have decreased vessel resistance.
Our current results comparing non-selective and selective beta-blockers suggest that the selective beta-blocker betaxolol may be more appropriate for maintenance of retinal blood flow in situations with low perfusion. Currently the mechanism for regulation of IOP is unclear; however, the findings from this study indicate that decreased CiBF may contribute to reduction in IOP.
在本研究中,评估了局部应用的非选择性β受体阻滞剂噻吗洛尔和卡替洛尔以及选择性β受体阻滞剂倍他洛尔对兔眼眼血流、眼压(IOP)和血管阻力的急性影响。
采用双盲随机设计,每组9只兔子,每只兔子的一只眼睛滴入两滴0.5%噻吗洛尔或2%卡替洛尔或0.5%倍他洛尔眼药水,另一组9只兔子双眼滴入两滴由生理盐水组成的安慰剂作为对照。使用氢清除法测量睫状体血流(CiBF)、脉络膜血流(CBF)和视网膜血流(RBF)。在给药前后相同条件下测量每只兔子的眼压和全身平均动脉压(MAP),以计算眼灌注压(OPP)和血管阻力。
与对照眼相比,噻吗洛尔和卡替洛尔治疗的眼睛眼压(p < 0.01)、CiBF(p < 0.01)、CBF(p < 0.01)和RBF(p < 0.01)均显著降低。然而,倍他洛尔治疗的眼睛眼压略有降低,同时CiBF(p < 0.01)和RBF(p < 0.05)显著增加。非选择性β受体阻滞剂治疗的眼睛血管阻力有增加趋势,而选择性β受体阻滞剂治疗的眼睛血管阻力有降低趋势。
我们目前比较非选择性和选择性β受体阻滞剂的结果表明,在低灌注情况下,选择性β受体阻滞剂倍他洛尔可能更适合维持视网膜血流。目前眼压调节机制尚不清楚;然而,本研究结果表明CiBF降低可能有助于眼压降低。