Cicek Meryem Feyza, Ağın Abdullah, Yakut Burcu, Baytaroglu Ata, Gelmis Mucahit, Ozgor Faruk, Onder Feyza
Department of Ophthalmology, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey.
Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey.
Neurourol Urodyn. 2025 Sep;44(7):1503-1511. doi: 10.1002/nau.70108. Epub 2025 Jun 25.
To assess the impact of mirabegron, a novel β3 adrenoceptor agonist employed for the treatment of overactive bladder (OAB), on the optic nerve head and chorioretinal vasculature using optical coherence tomography angiography (OCTA).
Fifty eyes of 25 patients who used a 50 mg tablet of mirabegron once daily for OAB were included in this prospective study. OCTA was performed at 6 × 6 mm of the macula and 4.5 × 4.5 mm of the optic disc. Retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex(mGCC) thickness, foveal avascular zone (FAZ), choriocapillaris (CC) flow area, CC vessel flow density (VFD), optic nerve head, and macula vessel densities were evaluated before the treatment and 2 months after treatment initiation.
RNFL, mGCC in all quadrants, and FAZ were similar before and 2 months after treatment started point. In optic nerve head vessel density measurements, whole image vessel density (wiVD), mean ppVD (peripapillary vessel density), inferior ppVD, and ppVD in nasal superior, inferior nasal, and temporal superior quadrants measurements following mirabegron treatment were found to be lower than the pretreatment measurements (p < 0.05). Following treatment, wiVD decreased by 1.2% (Cohen's d = 0.26) and mean ppVD decreased by 0.8% (Cohen's d = 0.25), indicating a small effect size. All macular parameters were similar before and 2 months after treatment. No statistically differences were observed in terms of CC parameters.
The reduction in optic nerve head vascularity parameters following mirabegron treatment contributes to understanding the impact of β3-AR agonists, which are being investigated as a therapeutic target for treating retinal vascular diseases. These findings may provide valuable insight into the systemic vascular effects of β3-adrenergic agonists and could be relevant in shaping therapeutic strategies aimed at preserving optic nerve head perfusion, particularly in patients at risk of vascular compromise. Further studies with larger cohorts and longer follow-up are needed to validate these preliminary findings.
This study is a prospective observational study and does not qualify as a clinical trial. Therefore, registration is not required.
使用光学相干断层扫描血管造影（OCTA）评估用于治疗膀胱过度活动症（OAB）的新型β3肾上腺素能受体激动剂米拉贝隆对视神经乳头和脉络膜视网膜血管系统的影响。
本前瞻性研究纳入了25例每天服用一次50毫克米拉贝隆片剂治疗OAB的患者的50只眼睛。在黄斑6×6毫米区域和视盘4.5×4.5毫米区域进行OCTA检查。在治疗前和治疗开始后2个月评估视网膜神经纤维层（RNFL）厚度、黄斑神经节细胞复合体（mGCC）厚度、中心凹无血管区（FAZ）、脉络膜毛细血管（CC）血流面积、CC血管血流密度（VFD）、视神经乳头和黄斑血管密度。
治疗开始时和治疗2个月后，RNFL、所有象限的mGCC以及FAZ相似。在视神经乳头血管密度测量中，发现米拉贝隆治疗后的全图像血管密度（wiVD）、平均视乳头周围血管密度（ppVD）、下方ppVD以及鼻上、鼻下和颞上象限的ppVD均低于治疗前测量值（p<0.05）。治疗后，wiVD下降了1.2%（Cohen's d=0.26），平均ppVD下降了0.8%（Cohen's d=0.25），表明效应量较小。治疗前和治疗2个月后所有黄斑参数相似。CC参数方面未观察到统计学差异。
米拉贝隆治疗后视神经乳头血管参数的降低有助于理解作为视网膜血管疾病治疗靶点正在研究的β3-AR激动剂的影响。这些发现可能为β3-肾上腺素能激动剂的全身血管效应提供有价值的见解，并且可能与制定旨在保留视神经乳头灌注的治疗策略相关，特别是在有血管受损风险的患者中。需要进行更大样本量和更长随访时间的进一步研究来验证这些初步发现。
本研究是一项前瞻性观察性研究，不符合临床试验标准。因此，无需注册。
