97th DOG Annual Meeting 1999



A. S. Bernd, L. E. Pillunat, A. G. Böhm, K. G. Schmidt*

Purpose: It has been shown that oral carbonic anhydrase inhibitors improve visual function in glaucoma. Furthermore topical dorzolamide might improve ocular hemodynamics, as it was demonstrated previously. This study was undertaken to evaluate whether topical dorzolamide affects visual function and ocular hemodynamics in glaucoma.

Methods: In a controlled, unmasked clinical trial dorzolamide eye drops were applied in 31 patients with confirmed primary open angle glaucoma (POAG) in both eyes, three times daily for a mean follow up of 9 months. One eye was randomly choosen for evaluation. IOP, blood pressure, heart rate and optic nerve blood flow, ocular pulse amplitudes (OPA), pulsatile ocular blood flow (POBF) and Humphrey 30-2 visual fields were measured at baseline and every 3 months after the start of the therapy. Laser scanning doppler flowmetry (HRF) was used to measure optic nerve blood flow and POBF was determined by pneumotonography (OBF-system, U.K.). For statistical analysis the Mann-Whitney-U-test and a regression analysis was used.

Results: IOP dropped in dorzolamide treated patients from 18 mmHg to 15 mmHg after 9 months therapy (p<0,01). And the visual field improved significantly from MD -11,71 dB to -8,06 dB (p<0,05). There was found a statistically not significant increase in optic nerve head blood flow (baseline: 508 AU; 9 month: 644 AU), but a significant change in POBF from 542 µl/min to 676µl/min (p<0,05). The regression analysis, however, did not show a significant correlation between visual field changes and the increase of POBF.

Conclusions: The results showed the expected drop in intraocular pressure. Visual function and pulsatile ocular blood flow improved significantly which might be explained by an analogous, vasodialtory effect as it was observed in orally applied carbonic anhydrase inhibitors.

University Eye Hospital Eppendorf, Martinistr. 52, D-20246 Hamburg*
University Eye Hospital Giessen, D-35385 Giessen