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The effects of antiglaucoma and systemic medications on ocular blood flow

Costa, Vital P; Harris, Alon; Stefansson, Einar; Flammer, Josef; Krieglstein, Gunter K; Orzalesi, Nicola; Heijl, Anders LU ; Renard, Jean-Paul and Metzner Serra, Luis (2003) In Progress in Retinal and Eye Research 22(6). p.769-805
Abstract
Based on the body of evidence implicating ocular blood flow disturbances in the pathogenesis of glaucoma, there is great interest in the investigation of the effects of antiglaucoma drugs and systemic medications on the various ocular vascular beds. The primary aim of this article was to review the current data available on the effects of antiglaucoma drugs and systemic medications on ocular blood flow. We performed a literature search in November 2002, which consisted of a textword search in MEDLINE for the years 1968-2002. The results of this review suggest that there is a severe lack of well-designed long-term studies investigating the effects of antiglaucoma and systemic medications on ocular blood flow in glaucomatous patients.... (More)
Based on the body of evidence implicating ocular blood flow disturbances in the pathogenesis of glaucoma, there is great interest in the investigation of the effects of antiglaucoma drugs and systemic medications on the various ocular vascular beds. The primary aim of this article was to review the current data available on the effects of antiglaucoma drugs and systemic medications on ocular blood flow. We performed a literature search in November 2002, which consisted of a textword search in MEDLINE for the years 1968-2002. The results of this review suggest that there is a severe lack of well-designed long-term studies investigating the effects of antiglaucoma and systemic medications on ocular blood flow in glaucomatous patients. However, among the 136 articles dealing with the effect of antiglaucoma drugs on ocular blood flow, only 36 (26.5%) investigated the effects of medications on glaucoma patients. Among these 36 articles, only 3 (8.3%) were long-term studies, and only 16 (44.4%) were double-masked, randomized, prospective trials. Among the 33 articles describing the effects of systemic medications on ocular blood flow, only 11 (33.3%) investigated glaucoma patients, of which only one (9.1%) was a double-masked, randomized, prospective trial. Based on this preliminary data, we would intimate that few antiglaucoma medications have the potential to directly improve ocular blood flow. Unoprostone appears to have a reproducible antiendothelin-1 effect, betaxolol may exert a calcium-channel blocker action, apraclonidine consistently leads to anterior segment vasoconstriction, and carbonic anhydrase inhibitors seem to accelerate the retinal circulation. Longitudinal, prospective, randomized trials are needed to investigate the effects of vasoactive substances with no hypotensive effect on the progression of glaucoma. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Progress in Retinal and Eye Research
volume
22
issue
6
pages
769 - 805
publisher
Elsevier
external identifiers
  • pmid:14575724
  • scopus:0142058595
ISSN
1873-1635
DOI
10.1016/S1350-9462(03)00064-8
language
English
LU publication?
yes
id
d2dd4bc1-aa73-4c8f-86f9-9bd71c819498 (old id 1126977)
date added to LUP
2008-06-10 12:04:52
date last changed
2018-01-07 05:57:37
@article{d2dd4bc1-aa73-4c8f-86f9-9bd71c819498,
  abstract     = {Based on the body of evidence implicating ocular blood flow disturbances in the pathogenesis of glaucoma, there is great interest in the investigation of the effects of antiglaucoma drugs and systemic medications on the various ocular vascular beds. The primary aim of this article was to review the current data available on the effects of antiglaucoma drugs and systemic medications on ocular blood flow. We performed a literature search in November 2002, which consisted of a textword search in MEDLINE for the years 1968-2002. The results of this review suggest that there is a severe lack of well-designed long-term studies investigating the effects of antiglaucoma and systemic medications on ocular blood flow in glaucomatous patients. However, among the 136 articles dealing with the effect of antiglaucoma drugs on ocular blood flow, only 36 (26.5%) investigated the effects of medications on glaucoma patients. Among these 36 articles, only 3 (8.3%) were long-term studies, and only 16 (44.4%) were double-masked, randomized, prospective trials. Among the 33 articles describing the effects of systemic medications on ocular blood flow, only 11 (33.3%) investigated glaucoma patients, of which only one (9.1%) was a double-masked, randomized, prospective trial. Based on this preliminary data, we would intimate that few antiglaucoma medications have the potential to directly improve ocular blood flow. Unoprostone appears to have a reproducible antiendothelin-1 effect, betaxolol may exert a calcium-channel blocker action, apraclonidine consistently leads to anterior segment vasoconstriction, and carbonic anhydrase inhibitors seem to accelerate the retinal circulation. Longitudinal, prospective, randomized trials are needed to investigate the effects of vasoactive substances with no hypotensive effect on the progression of glaucoma.},
  author       = {Costa, Vital P and Harris, Alon and Stefansson, Einar and Flammer, Josef and Krieglstein, Gunter K and Orzalesi, Nicola and Heijl, Anders and Renard, Jean-Paul and Metzner Serra, Luis},
  issn         = {1873-1635},
  language     = {eng},
  number       = {6},
  pages        = {769--805},
  publisher    = {Elsevier},
  series       = {Progress in Retinal and Eye Research},
  title        = {The effects of antiglaucoma and systemic medications on ocular blood flow},
  url          = {http://dx.doi.org/10.1016/S1350-9462(03)00064-8},
  volume       = {22},
  year         = {2003},
}