EXTENDED REPORT

Effects of brinzolamide on ocular haemodynamics in healthy volunteers

M Kaup, N Plange, M Niegel, A Remky and O Arend

Department of Ophthalmology, Aachen University, Aachen, Germany

Correspondence to:
Correspondence to:
Professor O Arend
Augenzentrum Alsdorf, Cäcilienstrasse 9, 52477 Alsdorf, Germany; oliver.arend{at}web.de

Aim: A prospective, randomised study to evaluate effects of brinzolamide on ocular haemodynamics in healthy volunteers.

Methods: 30 volunteers (12 men, 18 women; 28.3 (SD 7.8) years) were prospectively randomised to either brinzolamide or placebo during a 2 week double masked treatment trial. Examinations were performed at baseline and after 2 weeks of treatment. Intraocular pressure was measured and automatic static perimetry (Humphrey field analyser, 24-2) and contrast sensitivity (CSV 1000, Vector Vision) were performed. Retrobulbar blood flow velocities (peak systolic and end diastolic velocity) and resistive indices (RI) of ophthalmic artery, central retinal artery and of temporal and nasal short posterior ciliary arteries were measured by colour Doppler imaging (Sonoline Sienna Siemens). In video fluorescein angiograms (scanning laser ophthalmoscope, Rodenstock) arteriovenous passage time (AVP, dilution curves) and peripapillary diameters of retinal arterioles and venules were measured by means of digital image analysis.

Results: Intraocular pressure was significantly decreased by brinzolamide (p<0.0001). Neither brinzolamide nor placebo changed visual field global indices after treatment. Contrast sensitivity at 3 cycles per degree was significantly higher in the placebo group (p<0.05). Apart from an increase of RI in ophthalmic artery under placebo treatment (p<0.05) there was no effect in retrobulbar haemodynamics in both groups. Brinzolamide therapy alone resulted in a significant reduction of AVP compared to baseline (p<0.05), while peripapillary retinal vessels diameters remained unaffected.

Conclusions: Apart from the expected decrease of intraocular pressure brinzolamide showed no significant change in retrobulbar haemodynamics, but a significant shortening of AVP. Since in glaucoma AVP is prolonged indicating vascular dysfunction this effect might be beneficial in glaucoma therapy.

Keywords: brinzolamide; ocular haemodynamics

Abbreviations: AVP, arteriovenous passage time; BP, blood pressure; CAI, carbonic anhydrase inhibitors; CDI, colour Doppler imaging; cpd, cycles per degree; CPSD, corrected pattern standard deviation; CRA, central retinal artery; CS, contrast sensitivity; EDV, end diastolic velocity; HR, heart rate; MD, mean defect; OA, ophthalmic artery; OPP, ocular perfusion pressure; PCA, posterior ciliary artery; PSD, pattern standard deviation; PSV, peak systolic velocity; RI, resistive index; SF, short term fluctuation; SLO, scanning laser ophthalmoscope

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