Wolf S, Werner E, Schulte K, Reim M
Augenklinik der Medizinischen, Fakultät der Rheinisch-Westfälischen Technischen Hochschule Aachen, Germany.
Br J Ophthalmol. 1998 Aug;82(8):892-6. doi: 10.1136/bjo.82.8.892.
To assess the effect of topical and systemic application of a beta adrenergic receptor blocker on retinal haemodynamics.
24 healthy subjects were included in this double masked, randomised, placebo controlled crossover study. Metipranolol, a non-selective beta adrenergic receptor blocking agent was used as test drug. In all subjects arm-retina time, arteriovenous passage time, arterial mean dye velocity, the arterial vessel diameters, and capillary flow velocity were quantified from digital video fluorescein angiograms.
A significant effect was observed on the arteriovenous passage time (p < 0.05), the arterial mean dye bolus velocity (p < 0.05), and capillary blood velocity (p < 0.05), but not on the arterial vessel diameter. The arterial mean dye bolus velocity and capillary blood velocity increased after application of the test drug (topical and systemic). In tandem with this a decrease of the arteriovenous passage time was observed. The perfusion pressure increased after topical application and remained unchanged after systemic application of metipranolol.
This study shows that systemic as well as topical application of metipranolol leads to increased retinal blood flow velocities. The implications of these results for treatment with beta adrenergic receptor blockers is not clear. However, in view of these data it is very unlikely that treatment with metipranolol has a negative effect on retinal blood flow.
评估β肾上腺素能受体阻滞剂局部和全身应用对视网膜血流动力学的影响。
本双盲、随机、安慰剂对照交叉研究纳入了24名健康受试者。使用非选择性β肾上腺素能受体阻滞剂美替洛尔作为受试药物。在所有受试者中，通过数字视频荧光血管造影术对臂-视网膜时间、动静脉通过时间、动脉平均染料速度、动脉血管直径和毛细血管流速进行量化。
观察到对动静脉通过时间（p < 0.05）、动脉平均染料团块速度（p < 0.05）和毛细血管血流速度（p < 0.05）有显著影响，但对动脉血管直径无影响。应用受试药物（局部和全身）后，动脉平均染料团块速度和毛细血管血流速度增加。与此同时，观察到动静脉通过时间缩短。局部应用美替洛尔后灌注压升高，全身应用后灌注压保持不变。
本研究表明，美替洛尔全身及局部应用均可导致视网膜血流速度增加。这些结果对β肾上腺素能受体阻滞剂治疗的意义尚不清楚。然而，鉴于这些数据，美替洛尔治疗对视网膜血流产生负面影响的可能性极小。
