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Results of 1-year fixed combination glaucoma treatment

changes induced by the different treatments were not con- necessarily indicative on the hemodynamics of the small
sidered in the analysis. The DTFC treatment group showed retrobulbar vessels supplying the optic nerve.
statistically significant lower vascular resistance in retrob- A limitation of our study is that we have a small group of
ulbar vessels compared to the LTFC group after 1 year of patients followed up for 1 year. This is possibly too short a
randomized treatment. time period to see a difference in outcome that is unrelated
Plange et al (32) reported that retrobulbar hemodynam- to the IOP-lowering effect. In order to confirm or to refute
ics of the CRA and vein were correlated with the struc- our results, larger group studies with longer follow-up are
tural neuroretinal rim damage in POAG. Our patients did needed.
not have changes in nerve fiber parameters in either study
group. GDx VCC scanning laser polarimetry accuracy is
shown to exceed the required 85% sensitivity and 95% ACKNOWLEDGEMENTS
specificity for detecting moderate to severe glaucomatous
damage (33). Medeiros et al (34) reported that RNFL imag- Supported in part by an unrestricted grant from Research to
ing with GDx VCC has a superior performance compared Prevent Blindness.
to topographic optic disc assessment with the HRT when
these tests are combined with clinical examination of the I.J. and A.H. have each previously received research grants from Merck & Co.,
optic nerve. It is possible that 12 months of follow-up is Inc., Whitehouse Station, NJ.
too short to document progressive visual field and/or NFL The authors report no proprietary interest or financial support.
defects in correlation with ocular blood flow parameters.
BP and PP abnormalities have been identified in recent Reprint requests to:
years as vascular risk factors in patients with glaucoma Ingrida Januleviciene, MD
and in glaucoma progression. However, it remains unan- Associate Professor of Ophthalmology
swered whether manipulation in the PP, BP, and blood flow Eye Clinic of Kaunas University of Medicine
will change patient outcome in terms of progression rates. Eiveniu Str. 2
Kaunas 50009, Lithuania
Current glaucoma medications are targeted to decrease ingrida.januleviciene@kmuk.lt
the IOP and are not targeted to treat other hemodynamic
parameters. In our study, we found that although the treat- Alon Harris, MS, PhD
Lois Letzter Professor of Ophthalmology
ments had some differences in the RI of the OA and SPCA Professor of Physiology and Biophysics
after 1 year, they had similar functional and structural out- Department of Ophthalmology
comes. We found that both treatments increased the PSV Indiana University School of Medicine
702 Rotary Circle, Room 137
and EDV of the OA at all study visits, which implies that the Indianapolis, IN 46202
blood velocity in the OA was increased, although it is not harrisal@netvision.net.il

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