472 Inhibiteurs des canaux calciques dans l’hémodynamique oculaire du glaucome

Abstract

To investigate Ca blockers effect on the ocular hemodynamic in glaucoma patients. Clinical, observational, prospective study on two groups of patients with primary open angle glaucoma (POAG): group A – 15 patients with hypertensive POAG and group B – 8 patients with normal tension POAG. Both groups of patients received oral therapy with nimodipinum (30mg × 3/zi) – a Ca blocker with preponderent vascular effect mainly in cerebral circulation. For each patient the intraocular pressure (IOP), the arterial pressure and the hemodynamic activity in the central artery of the retina by color Doppler imaging were measured at the begining of the study and after 3 weeks of treatment. Exclusion criteria was any associated ocular or general pathology. Both groups were homogeneous by age and sex. ocular hemodynamic: the peack sistolic velocity (PSV), the end diastolic velocity (EDV) and the resistivity index (RI) in the central artery of the retina show that at the begining of the study group B has the velocities values lower than group A. At 3 weeks post-treatment, we observe an amelioration of these values by statistically significativ increases of PSV and EDV and decrease of RI. We did not notice the alterations on IOP or hypo-arterial tensions episodes. In the plurifactorial etiopathology of the glaucoma, impaired ocular perfusion is an important coparticipant factor. We have to find out the easiest way to be efficient in this part of treatment. This study demonstrates that the involvement of ocular blood flow is an important factor in the pathogenesis of the glaucoma, the hemodynamic alterations being increased in the normal tension glaucoma. Action of nimodipinum on vasoconstriction and vasospasm as a potent cerebral vasoactive agent has to be studied.