Page 131 - DUOKOPT BIBLIOBOOK

EFFICACY

Januleviciene et al

TABLE III - HUMPHREY VISUAL FIELD PARAMETERS: MEAN DEVIATION (MD) AND PATTERN STANDARD DEVIATION
(PSD) CHANGES
Baseline Treatment groups
6 mo 12 mo
MD DTFC −0.423 (0.94) −0.51 (0.71) −0.57 (1.38)
LTFC −1.20 (1.95) −1.02 (2.50) −1.63 (2.60)
PSD DTFC 1.48 (0.34) 1.52 (0.35) 1.51 (0.29)
LTFC 2.56 (2.08) 2.26 (2.07) 2.78 (2.63)
DTFC = dorzolamide/timolol; LTFC = latanoprost/timolol

TABLE IV - GLAUCOMATOUS OPTIC NEUROPATHY STRUCTURAL CHANGES EVALUATED BY GDx VCC
Baseline Treatment groups
6 mo 12 mo

TSNIT DTFC 54.92 (6.67) 55.77 (5.80) 54.10 (5.46)
LTFC 52.12 (6.57) 52.43 (5.97) 52.29 (6.36)
NFI DTFC 21.07 (7.13) 21.93 (4.95) 23.07 (5.59)
LTFC 25.47 (12.20) 24.13 (7.41) 25.53 (12.36)
TSNIT = temporal, superior, nasal, inferior, temporal; DTFC = dorzolamide/timolol; LTFC = latanoprost/timolol; NFI = nerve fiber indicator.

found increased blood flow in patients with OAG treated healthy controls. Both our study groups showed increase
with fixed combination of timolol and dorzolamide therapy in the PSV of the OA and the CRA and increase in the EDV
compared to latanoprost plus timolol. In their study as in of OA after switching from timolol at baseline to combi-
ours both fixed combinations had a similar IOP reduction nation treatment regimen. Blood flow velocity changes
effect and patients maintained stable visual function with a were statistically significant for the EDV of the SPCA at the
short follow-up of 4 weeks. Ocular blood flow is influenced 12-month visit (p=0.007, t test). During 1 year of observa-
by PP (including IOP), vascular resistance, and autoregula- tion, the RI of the CRA decreased in the DTFC treatment
tion. We need to remember that by evaluating retrobulbar group, while it increased in the LTFC treatment group.
hemodynamics with CDI we actually measure blood flow Galassi et al (31) observed patients with glaucoma for 7
velocity and calculate the RI but since we do not measure years and evaluated the effect of optic nerve circulation
vessel diameter we do not measure the blood flow. measured with CDI on visual field outcome. They found
Plange et al (29) found that patients with asymmetric glau- that the visual field deterioration in patients with an OA RI
comatous visual field loss also exhibit asymmetric flow of 0.78 or higher was about 6 times that of patients with
velocities of the CRA and OA. Patients with more severe an OA RI lower than 0.78. In our study, the OA RI in the
damage display reduced flow velocities in the retrobulbar LTFC treatment group was 0.8200 (0.173) and the OA RI
vessels in POAG. Zeitz et al (30) further concluded that in the DTFC treatment group was 0.7213 (0.117) (p<0.05),
progressive glaucoma is associated with decreased blood but despite that we did not find changes in the visual fields,
flow velocities in the small retrobulbar vessels supplying which can result from too short follow-up. In the Galassi
the optic nerve head. They found no differences in the OA et al study (31), CDI examinations were performed shortly
blood flow velocities between patients with progressing after diagnosis of glaucoma, and before initiation of anti-
glaucoma compared to patients with stable glaucoma and glaucomatous therapy or other treatment modalities. The

795

EJO_790-797_Janule.indd 795 3-08-2009 14:04:15

131