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Ophthalmic Artery Hemodynamics in Primary Open-angle Glaucoma Patients on Brimonidine
1Stützle C., 1Schmidt K.-G., 2Klingmüller V., 1Böhm A. G., 1Pillunat L. E.,
1Universitätsklinikum Carl Gustav Carus, Klinik und Poliklinik für Augenheilkunde (Dresden)
2Radiologische Abteilung der Universitätsklinik (Gießen)
Purpose: Good evidence exists to suggest that ocular hemodynamics influence the prognosis of primary open angle glaucoma (POAG). This study was designed to evaluate the influence of brimonidine, a potentially vasoconstrictive alpha-2-adrenoceptor agonist, on ophthalmic artery (OA) hemodynamics in POAG patients.
Methods: The influence of standard dosage brimonidine (0.2%, BID, one eye) on intraocular pressure (IOP), OA hemodynamics (9 MHz linear and phased array scanners, Elegra Advanced System, Siemens, Germany, transmission energy reduced to 40%, B-, C-, & triplex-modes), and systemic perfusion parameters was determined in 17 POAG patients where clinically relevant extracranial stenosis (< 50% reduction in vessel diameter) was excluded based on the sonography of the common, external and internal carotid arteries. Measurements were taken before, and after four weeks of brimonidine therapy.
Results: Values represent mean ± SD. Following application of brimonidine the IOP (mmHg) in drug treated POAG eyes was significantly (p< 0.0001) reduced from 26.4 ± 1.3 to 21.5 ± 1.6. When compared to pretreatment values OA perfusion parameters (peak systolic velocity: 30.7 ± 2.2 cm/s; enddiastolic velocity: 6.5 ± 1.5 cm/s, resistance: 0.79 ± 0.05 and pulsatility: 1.19 ± 0.19 indexes) were unaffected by brimonidine. Systemic perfusion parameters were also unaltered by brimonidine.
Conclusion: Brimonidine reduced IOP by 18.7%. Moreover, no evidence was found for a negative effect of brimonidine on OA hemodynamics in POAG patients.