Optic nerve head PERFUSION AND ENDOTHELIN-1 IN PRIMARY OPEN ANGLE GLAUCOMA PATIENTS ON UNOPROSTONE AND LATANOPROST

K.-G. Schmidt,1 V. Klingmüller,2 D. Auch,2 and  B. Link1

Universities of Oxford 1, UK, and Giessen,2 Germany.

Purpose Reduction of short posterior ciliary artery (SPCA) hemodynamics and ocular pulse amplitude (OPA), a measure of choroidal perfusion and an increase in endothelin-1 (ET-1), a potent vasoconstrictor are associated with progression of glaucomatous damage. This study was designed to evaluate the influence of 2 topical antiglaucomatous agents on SPCA and choroidal vascular systems in primary open angle glaucoma (POAG) patients.

Methods The influence of the docosanoid unoprostone (UIOS) and the PGF2alpha analogue latanoprost (LOS), both drugs being administered as adjunct to timolol, on SPCA (Elegra Advanced System, Siemens, Germany), OPA (OBF-System, OBF Labs UK), serum ET-1 (ELISA, R&D Systems, Germany), IOP, and systemic perfusion parameters was investigated in both eyes of 23 POAG patients. Measurements were taken before and 4 weeks after application of respective drugs.

Results (mean ± SD) When compared to pretreatment values OPA (mmHg) was significantly (sig., p= 0.001) decreased in LOS (2.20 ± 0.37 / 2.03 ± 0.34) and borderline sig. (p= 0.062) increased in UIOS (2.13 ± 0.38 / 2.20 ± 0.40) treated eyes. ET-1 (pg/ml) was borderline sig. (p= 0.056) increased in latanoprost (0.62 ± 0.19 / 0.75 ± 0.18) and unchanged (p= 0.951) in UIOS (0.79 ± 0.23 / 0.79 ± 0.29) treated eyes. SPCA perfusion parameters (peak systolic and enddiastolic velocities, pulsatility and resistance indexes and systemic perfusion parameters were not sig. (p> 0.05) altered in either group.

Conclusion LOS reduces OPA and increases ET-1, whereas UIOS with its 22 carbon structure has a favorable effect on ocular hemodynamics.