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Impressum
Contrast sensitivity, short wavelength automated perimetry and retinal hemodynamics in glaucoma therapy
Plange N., Remky A., Huber K., Hendricks S., Arend O.
Augenklinik der RWTH Aachen, Pauwelsstr. 30, 52072 Aachen, Germany
Purpose: To evaluate the effects of dorzolamide, timolol and latanoprost
on contrast sensitivity, short wavelength automated perimetry (SWAP) and
retinal hemodynamics in newly diagnosed open-angle glaucoma (POAG).
Methods: In a prospective randomized crossover study, 14 patients
with POAG (age 55 ±7 years, 10 male, 4 female) were examined at
baseline, and after a 4 weeks therapy with dorzolamide, timolol or latanoprost
respectively. In videofluorescein angiography (Scanning Laser Ophthalmoscopy)
arteriovenous passage times (AVP) and peripapillary retinal vessel diameters
were measured by means of digital image analysis. Intraocular pressure
was measured, automatic static perimetry (SWAP) and static contrast sensitivity
(CSV 1000, VectorVision) was performed.
Results: Intraocular pressure was significantly reduced from baseline
by all medications (p<0,0001), with no difference between medications.
Dorzolamide significantly reduced AVP compared to baseline (p<0,01,
baseline 2,53 ±0,72s, dorzolamide 1,94 ±0,58s). Peripapillary
vessel diameters remained unaffected at all visits. Visual Field Indices
(SWAP) showed no statistical differences between visits. Visual function
as measured by contrast sensitivity (6 cycles per degree) was significantly
higher with dorzolamide compared to timolol (p=0,04).
Discussion: Dorzolamide alone showed a significant reduction of
the AVP in newly diagnosed POAG. The prolongation of the AVP is known
to correlate with progression of retinal disease (diabetic retinopathy,
vein occlusion). Therefore, a therapeutical reduction of the AVP might
be benefitial. In addition, Dorzolamide improved contrast sensitivity
compared to timolol.