University Hospital Basel, Basel, Switzerland.
Curr Med Res Opin. 2010 Jun;26(6):1255-67. doi: 10.1185/03007991003738485.
Dorzolamide and brinzolamide are topical carbonic anhydrase inhibitors (CAI) indicated for patients with glaucoma and ocular hypertension.
An evidence-based review of clinical trials of dorzolamide and brinzolamide was undertaken to determine an effect of these medications on visual function (primarily visual field) in open-angle glaucoma and ocular hypertension. Using the keywords 'dorzolamide' and 'brinzolamide', all articles describing trials of these medications reporting on visual acuity, contrast sensitivity and visual field from September 1966 to July 2009 were found in MEDLINE and EMBASE databases. No information from other sources was included in this review.
A relatively modest number of trials was identified, where impact of therapy on one or more of the visual function modes was reported. In the studies of less than 1 year duration (3 days to 1 year, 23 studies) in all but three studies treatment with topical CAIs did not influence visual function, in two studies with dorzolamide some improvement in the contrast sensitivity was observed and in one open-label retrospective no-control-group study with dorzolamide visual field indices improved significantly. A different picture was seen in long-term studies, which were designed and powered to detect changes in visual field. One large study (European Glaucoma Prevention Study) with dorzolamide versus placebo failed to detect significant protective effect of the drug on glaucoma occurrence in ocular hypertensives. Several interesting aspects of this study are discussed in detail. The other two long-term studies reported on the superiority of adding dorzolamide over timolol therapy alone, and the superiority of the combination of dorzolamide and timolol over brinzolamide and timolol in terms of improving ocular blood flow (retrobulbar Color Doppler Imaging--CDI parameters) as well as in terms of visual field preservation in glaucoma patients over 4 to 5 years.
For the first time one study could demonstrate that an improvement in ocular blood flow in the long run results in preservation of visual field in glaucoma patients. Dorzolamide, combined with the beta-blocker timolol, seems to be superior in this regard to brinzolamide plus timolol.
多佐胺和布林佐胺是局部碳酸酐酶抑制剂（CAI），用于治疗青光眼和高眼压症患者。
对多佐胺和布林佐胺的临床试验进行了基于证据的综述，以确定这些药物对开角型青光眼和高眼压症患者的视觉功能（主要是视野）的影响。使用关键词“多佐胺”和“布林佐胺”，在 MEDLINE 和 EMBASE 数据库中检索到所有描述这些药物试验的文章，这些文章报告了视力、对比敏感度和视野从 1966 年 9 月到 2009 年 7 月的数据。本综述未包括其他来源的信息。
确定了相对较少数量的试验，其中报告了治疗对一种或多种视觉功能模式的影响。在持续时间不到 1 年的研究中（3 天至 1 年，23 项研究），除了三项研究外，局部 CAI 治疗并未影响视觉功能，在两项多佐胺研究中观察到对比敏感度有所改善，在一项多佐胺开放性回顾性无对照组研究中，视野指数显著改善。在旨在检测视野变化的长期研究中，情况则不同。一项大型多佐胺与安慰剂的欧洲青光眼预防研究未能检测到药物对高眼压患者发生青光眼的显著保护作用。该研究的几个有趣方面进行了详细讨论。另外两项长期研究报告了在单独使用噻吗洛尔治疗的基础上添加多佐胺的优越性，以及在改善青光眼患者的眼血流（眼后 Color Doppler 成像-CDI 参数）和 4 至 5 年内保护视野方面，多佐胺联合噻吗洛尔优于布林佐胺联合噻吗洛尔。
首次有一项研究证明，长期改善眼血流可导致青光眼患者的视野得到保护。多佐胺联合β受体阻滞剂噻吗洛尔在这方面似乎优于布林佐胺联合噻吗洛尔。
