COMPARATIVE STUDY OF NEURORETINOPROTECTIVE EFFICIENCY OF HYPOTENSIVE PREPARATIONS

Prof. Alexeev V.N., Martynova E.B. M.D., Sadkov V.I. M.D. and
Usachev V.V

Saint-Petersburg State Medical Academy named after I.I.Mechnykov

Russia

An ideal medicinal agent for the treatment of primary open angle glaucoma would be a preparation for local application, which could reduce intraocular pressure (IOP) to the level of “target pressure” and influence on numerous risk factors in glaucoma. However, there is no preparation of this kind at present.

The purpose of our work was to study a hypotensive and possibly neuroprotective action of the most frequently used hypotensive preparations for the treatment of glaucoma.

The treatment of 200 patients (400 eyes) with primary open angle glaucoma was carried out. For the treatment of the patients the following preparations were used: normoglaucon, epinefrine 2%, dipivefrin 0,1%, Fotil, betoptic-S and erisod. The period of therapy lasted for 6 months.

The level of  ophtalmotonus, changes of central and peripheral field of vision, indices of glaucoma process stabilization, and electrophysiological indices were controlled during our investigation. All adverse events were also marked.

Fotil was the most effective hypotensive drug among the studied preparations. It reduced IOP by 34%. The hypotensive efficiency of other preparations ranged between 24 at 31%. However, despite IOP normalization in the groups treated with photil, normoglaucon, epinefrine, dipivefrin the progress of glaucoma process was revealed in 12% of cases. It shows that the preparations influenced on the level of IOP only, leaving other risk factors beyond attention.

The applicftion of betoptic-S and its combination with erisod allowed not only to normalize IOP but also maintain functions of vision in all the patients of these groups during the whole term of observation. This fact together with the positive dynamics of electrophysiological investigations allow us to suppose that these medicinal agents have some definite neuroprotective action.