Effect of latanoprost 0.005% and brimonidine tartrate 0.2% on pulsatile ocular blood flow in normal tension glaucoma

Aim: To determine the effect of brimonidine tartrate 0.2% and latanoprost 0.005% on pulsatile ocular blood flow (POBF) in patients with normal tension glaucoma (NTG). Method: NTG patients with progressive optic neuropathy, new disc haemorrhage, or field defects that threatened fixation were enrolled into a randomised, investigator masked, crossover study. Group I patients received 4 weeks each of latanoprost, lubricant, and brimonidine, while group II patients received 4 weeks each of brimonidine, lubricant, and latanoprost. Diurnal POBF was measured at baseline and after each 4 week treatment. Results: 25 patients completed the study and had reliable POBF measurement at each visit. There was no significant diurnal change in baseline POBF (p = 0.768). Latanoprost increased POBF by 213 (SD 257) μl/min (22.8%, p <0.001) while brimonidine increased it by 97 (183) μl/min (10.4%, p = 0.014). POBF increased at 8 am (p = 0.004), 12 noon (p = 0.002), and 4 pm (p <0.001) with latanoprost, while it increased only at 8 am (p = 0.016) with brimonidine. After adjusting for the factor of IOP, neither latanoprost nor brimonidine increased POBF significantly. Conclusions: Latanoprost increases the mean POBF that is related to its IOP lowering effect. The increase in POBF noted after brimonidine is within the range of long term variation and may not be attributable to the drug effect.

[1]  J. Faber,et al.  Selective interaction of alpha-adrenoceptors with myogenic regulation of microvascular smooth muscle. , 1990, The American journal of physiology.

[2]  S. Graham,et al.  Ambulatory blood pressure monitoring in glaucoma. The nocturnal dip. , 1995, Ophthalmology.

[3]  M. Nicolela,et al.  A comparative study of the effects of timolol and latanoprost on blood flow velocity of the retrobulbar vessels. , 1996, American journal of ophthalmology.

[4]  M Schulzer,et al.  Response of blood flow to warm and cold in normal and low-tension glaucoma patients. , 1988, American journal of ophthalmology.

[5]  J. Kiel,et al.  Effects of latanoprost and timolol-XE on hydrodynamics in the normal eye. , 2000, American journal of ophthalmology.

[6]  R. Hitchings,et al.  Surgery for normal tension glaucoma. , 1995, The British journal of ophthalmology.

[7]  C. O'brien,et al.  Pulsatile ocular blood flow investigation in asymmetric normal tension glaucoma and normal subjects , 1998, The British journal of ophthalmology.

[8]  R. Leblanc,et al.  The effect of brimonidine tartrate on retinal blood flow in patients with ocular hypertension. , 2000, American journal of ophthalmology.

[9]  Correlation of asymmetric damage with asymmetric intraocular pressure in normal-tension glaucoma (low-tension glaucoma). , 1988, Archives of ophthalmology.

[10]  M. Langham,et al.  A clinical procedure for the measurements of the ocular pulse-pressure relationship and the ophthalmic arterial pressure. , 1978, Experimental eye research.

[11]  M. Batterbury,et al.  Pulsatile ocular blood flow measurements in healthy eyes: reproducibility and reference values. , 1997, Journal of glaucoma.

[12]  Richard Sutton,et al.  Factors influencing the ocular pulse — the heart rate , 2004, Graefe's Archive for Clinical and Experimental Ophthalmology.

[13]  L. Andries,et al.  Contractile responses of isolated bovine retinal microarteries to acetylcholine. , 1991, Investigative ophthalmology & visual science.

[14]  M. McKibbin,et al.  The effect of once-daily latanoprost on intraocular pressure and pulsatile ocular blood flow in normal tension glaucoma , 1999, Eye.

[15]  J. Stjernschantz,et al.  Effect of latanoprost on regional blood flow and capillary permeability in the monkey eye. , 1999, Archives of ophthalmology.

[16]  S. Hayreh,et al.  Nocturnal arterial hypotension and its role in optic nerve head and ocular ischemic disorders. , 1994, American journal of ophthalmology.

[17]  F. Ederer.  Migraine and low-tension glaucoma. A case control study. , 1986, Investigative ophthalmology & visual science.

[18]  J. Jonas,et al.  Pressure-dependent neuroretinal rim loss in normal-pressure glaucoma. , 1998, American journal of ophthalmology.

[19]  R. Brubaker,et al.  The effects of withdrawal of timolol in chronically treated glaucoma patients. , 1988, Ophthalmology.

[20]  T. Hassard,et al.  Applied Linear Regression , 2005 .

[21]  C. James,et al.  Effect of trabeculectomy on pulsatile ocular blood flow. , 1994, The British journal of ophthalmology.

[22]  S. Weisberg,et al.  Applied Linear Regression (2nd ed.). , 1986 .

[23]  C. O'brien,et al.  Reproducibility of Pulsatile Ocular Blood Flow Measurements , 1995, Journal of glaucoma.

[24]  C E Krakau,et al.  Calculation of the pulsatile ocular blood flow. , 1992, Investigative ophthalmology & visual science.

[25]  M. Johnson,et al.  Washout periods for brimonidine 0.2% and latanoprost 0.005%. , 2001, American journal of ophthalmology.

[26]  J. Schuman,et al.  Brimonidine tartrate: a one-month dose response study. , 1997, Ophthalmology.

[27]  M. Zimmerman,et al.  Beta-blocker eyedrops and nocturnal arterial hypotension. , 1999, American journal of ophthalmology.

[28]  G. Seong,et al.  Effects of 0.005% Latanoprost on Optic Nerve Head and Peripapillary Retinal Blood Flow , 1999, Ophthalmologica.

[29]  S. Dhanjil,et al.  Effect of brimonidine tartrate on ocular hemodynamic measurements. , 1998, Archives of ophthalmology.

[30]  P Schilder,et al.  Estimation of pulsatile ocular blood flow from intraocular pressure , 1989, Acta ophthalmologica. Supplement.

[31]  Evon M. O. Abu-Taieh,et al.  Comparative Study , 2020, Definitions.

[32]  J. Flammer,et al.  Systemic blood pressure in glaucoma patients , 1993, Graefe's Archive for Clinical and Experimental Ophthalmology.

[33]  D. Silver,et al.  Acute effect of latanoprost on pulsatile ocular blood flow in normal eyes. , 2001, American journal of ophthalmology.

[34]  L. Pasquale,et al.  The cardiovascular, pulmonary, and ocular hypotensive effects of 0.2% brimonidine. , 1995, Archives of ophthalmology.

[35]  Douglas R. Anderson,et al.  Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. Collaborative Normal-Tension Glaucoma Study Group. , 1998, American journal of ophthalmology.

[36]  Y. Liao,et al.  Ambulatory blood pressure. , 1995, Hypertension.

[37]  S. Zeger,et al.  Longitudinal data analysis using generalized linear models , 1986 .

[38]  A. Crichton,et al.  Unequal intraocular pressure and its relation to asymmetric visual field defects in low-tension glaucoma. , 1989, Ophthalmology.

[39]  Janet B. Serle,et al.  A comparison of the safety and efficacy of twice daily brimonidine 0.2% versus betaxolol 0.25% in subjects with elevated intraocular pressure. The Brimonidine Study Group III. , 1996, Survey of ophthalmology.