Abreu M M, Kim Y Y, Shin D H, Netland P A
The Eye and Ear Institute, University of Pittsburgh, Pennsylvania, USA.
Ophthalmology. 1998 Dec;105(12):2251-5. doi: 10.1016/S0161-6420(98)91224-6.
To investigate the effect of a single-dose and 2-week administration of topical 0.25% verapamil on episcleral venous pressure (EVP) and intraocular pressure (IOP).
A prospective, randomized, double-masked, crossover, and placebo-controlled study.
One eye of each of 20 normal subjects received topical verapamil or placebo.
The EVP was measured using a pressure chamber episcleral venomanometer. The IOP, EVP, heart rate (HR), and blood pressure (BP) were measured at baseline, 1.5 hours after a single drop, and after 2-week, three-times-a-day topical administration of 0.25% verapamil or placebo to one eye. After a 4-week washout period, the treatment to the study eye was reversed, and measurements of EVP, IOP, HR, and BP were repeated.
The EVP, IOP, HR, and BP were measured.
Ninety minutes after a single drop, the EVP in the verapamil-treated eyes was reduced by 4.8% (P = <0.001) and in the untreated fellow eyes by 2.4% (P = 0.032). After 2-week topical administration, the EVP was reduced by 9.5% (P = <0.0001) in the verapamil-treated eyes and by 4.8% (P = 0.001) in the fellow eyes. The EVP was unchanged in the treated and fellow eyes after a single drop or after a 2-week treatment with placebo. Ninety minutes after topical administration of 0.25% verapamil, the IOP decreased by 7.7% (P = <0.0001) in the treated eyes and decreased by 3.6% (P = 0.03) in the fellow eyes. After a 2-week administration of topical verapamil, the IOP decreased by 12% (P = 0.0001) in the treated eyes and by 7.2% (P = 0.0289) in the fellow eyes. The changes of IOP in the placebo-treated and fellow eyes were not statistically significant after a single-dose and 2-week administration. After topical administration of verapamil, a contralateral effect on IOP and EVP was observed in the fellow, untreated eye. No systemic effect on HR or BP was detected after a single-dose administration of topical verapamil. There were, however, significant reductions in HR and BP after a 2-week treatment with topical 0.25% verapamil.
These results indicate that a single drop and a 2-week administration of topical 0.25% verapamil decrease IOP and EVP significantly, with more pronounced reduction after a 2-week treatment than after a single-dose treatment.
研究局部应用0.25%维拉帕米单剂量及连续2周给药对巩膜静脉压（EVP）和眼压（IOP）的影响。
一项前瞻性、随机、双盲、交叉、安慰剂对照研究。
20名正常受试者的单眼接受局部维拉帕米或安慰剂治疗。
使用压力室巩膜静脉压计测量EVP。在基线、单滴药后1.5小时以及对一只眼每日三次局部应用0.25%维拉帕米或安慰剂2周后，测量眼压、EVP、心率（HR）和血压（BP）。经过4周的洗脱期后，对研究眼的治疗进行反转，并重复测量EVP、IOP、HR和BP。
测量EVP、IOP、HR和BP。
单滴药90分钟后，维拉帕米治疗眼的EVP降低了4.8%（P = <0.001），未治疗的对侧眼降低了2.4%（P = 0.032）。局部给药2周后，维拉帕米治疗眼的EVP降低了9.5%（P = <0.0001），对侧眼降低了4.8%（P = 0.001）。单滴药或用安慰剂局部治疗2周后，治疗眼和对侧眼的EVP均未改变。局部应用0.25%维拉帕米90分钟后，治疗眼的IOP降低了7.7%（P = <0.0001），对侧眼降低了3.6%（P = 0.03）。局部应用维拉帕米2周后，治疗眼的IOP降低了12%（P = 0.0001），对侧眼降低了7.2%（P = 0.0289）。单剂量及2周给药后，安慰剂治疗眼和对侧眼的IOP变化无统计学意义。局部应用维拉帕米后，在未治疗的对侧眼中观察到对IOP和EVP有对侧效应。局部应用维拉帕米单剂量给药后未检测到对HR或BP的全身效应。然而，局部应用0.25%维拉帕米治疗2周后，HR和BP有显著降低。
这些结果表明，局部应用0.25%维拉帕米单滴药及连续2周给药可显著降低IOP和EVP，2周治疗后的降低幅度比单剂量治疗后更明显。
