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The Effect of Brinzolamide (Azopt®) and Dorzolamide (Trusopt®) on Ocular Perfusion - Measured by Colour Decoded Doppler Imaging (CDI)
Reuss J., Zeitz O., Matthiessen E. T., Richard G., Klemm M.,
Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Augenheilkunde (Hamburg)
Purpose: The pathogenesis of glaucomas is still uncertain. Beyond an elevated intraocular pressure (IOP) disturbance of ocular hemodynamics is increasingly discussed as a co-factor in the development of the glaucomas. In the first place classical local therapy aims at the reduction of the IOP. Effects of the routinly given substances of carboanhydrase-inhibitors on ocular perfusion are hardly examined.
Methods: 8 eyes were examined by Colour Decoded Imaging (CDI) before and during therapy with Dorzolamide (Trusopt®) and 10 eyes before and during therapy with Brinzolamide (Azopt®). The CDI-measurements were performed with a 7.5 MHz phased array applicator 7.5L40, Sonoline Elegra Advanced System (Siemens, Erlangen, Germany). The flow in the ophthalmic artery (AO), the central retinal artery (ACR), and the short posterior ciliary arteries (ACPB) were measured. IOP was measured using a Goldmann´s applanation tonometer.
Results: Dorzolamide and Brinzolamide decreased the IOP on average by 25.4±8 % and 18.5±7.0 % resp. During Dorzolamide therapy, the peak systolic velocity (PSV) in the AO increased from 25.5±1.0 cm/s to 35.1±4.6 cm/s (p<0.05, n=10), and in the short posterior ciliary artery from 9.0±1.5 cm/s to 11.8±1.5 cm/s. Under Brinzolamide the PSV in the AO decreased from 33.2±3.7 cm/s to 25.7±2.7 cm/s (p<0.05, n=10), while velocities in the short posterior ciliary artery decreased slightly, but statistically insignificant. The enddiastolic velocity in the AO was diminished from 7.1±1.4 cm/s to 4.5±0.7 cm/s (p< 0.05, n=10) and remained stabile under Dorzolamide.
Conclusions: The effect of reducing IOP of both drugs is comparable, but ocular perfusion is influenced contrary: Dorzolamide increases and Brinzolamide reduces the flow velocity in the retrobulbar vessels measured by CDI. Further studies are necessary to elucidate the consequences of this observation for the clinical use of these drugs.