Dorzolamide–timolol combination and retinal vessel oxygen saturation in patients with glaucoma or ocular hypertension
- S Traustason1,2,
- S H Hardarson1,2,
- M S Gottfredsdottir2,
- T Eysteinsson1,3,
- R A Karlsson4,
- E Stefánsson1,2,
- A Harris5
- 1Department of Ophthalmology, University of Iceland, Reykjavik, Iceland
- 2Department of Ophthalmology, Landspítali University Hospital, Reykjavik, Iceland
- 3Department of Physiology, University of Iceland, Reykjavik, Iceland
- 4Department of Electrical and Computer Engineering, University of Iceland, Reykjavik, Iceland
- 5School of Medicine, Indiana University, Indianapolis, Indiana, USA
- Correspondence to Professor E Stefánsson, Landspítali University Hospital, Department of Ophthalmology, Reykjavík, Iceland;
- Accepted 20 February 2009
- Published Online First 4 May 2009
Aims: To examine whether the addition of dorzolamide to timolol monotherapy influences oxygen saturation in the human retina.
Methods: Non-invasive spectrophotometric retinal oximetry was used to measure oxygen saturation in retinal vessels. Twenty patients with open-angle glaucoma (11) and ocular hypertension (9) were recruited. The patients were randomised into receiving timolol monotherapy or dorzolamide–timolol combination for an 8-month test period, followed by a second test period, before which the patients switched treatments. Oximetry measurements were performed at 2-month intervals during each period. Of the 20 patients, 13 followed the study protocol into the second test period, and 10 managed all study visits.
Results: The oxygen saturation in retinal vessels was stable within the test periods. The mean arteriolar saturation was 96 (2)% (mean (SD)) during timolol monotherapy and 97 (2)% during dorzolamide–timolol combination therapy (p = 0.17, all patients pooled, n = 13). Corresponding values in venules were 66 (5)% during timolol monotherapy and 65 (6)% during dorzolamide–timolol therapy (p = 0.13). Patients who started on dorzolamide–timolol combination showed a significant reduction in arteriolar (98 (2)% to 95 (2)%, p<0.01) and venular saturation (69 (5)% to 66 (6)%, p<0.05) when changing to timolol monotherapy.
Conclusion: Adding dorzolamide to timolol monotherapy has a minimal effect, but going from dorzolamide–timolol combination to timolol alone lowered arteriolar and venular oxygen saturation. The retinal oxygen saturation measurements show a high degree of stability over an extended period of time. Previous studies have suggested increased retinal and optic nerve blood flow with dorzolamide. Unchanged oxygen saturation and increased blood flow would indicate increased oxygen delivery to the retina.
Competing interests Research support from Merck.
Ethics approval Ethics approval was provided by the Icelandic National Bioethics Committee Office.
Patient consent Obtained.