Effect of Tafluprost and Tafloprost/Timolol on the Optic Nerve Head, Peripapillary and Macular Microcirculation According to OCT-Angiography

Abstract

Relevance. The ability of antiglaucoma drugs to improve ocular hemoperfusion is an important aspect of their action. Tafluprost is the first prostaglandin analogue (PA) containing no preservatives. The efficacy and safety of tafluprost, as well as tafluprost/timolol fixed combination (FC), was demonstrated in randomized multicenter trials. However, there is no literature on the effect of tafluprost and it’s FC on peripapillary and macular blood flow.Purpose. to assess the effect of tafluprost and tafloprost/timolol on the microcirculation in the optic nerve head, peripapillary area and macula in patients with primary open-angle glaucoma (POAG) according to OCT angiography (OCT-A).Patients and methods. OCT-A was performed in dynamics with an interval of a week in 36 patients (36 eyes) with a newly diagnosed initial stage of POAG, 12 received tafluprost, 12 — tafluprost/timolol FCs, 12 eyes represented control group (no drugs were prescribed). The change in IOP, mean perfusion pressure (PP) of the eye, and vessel density (VD) inside the optic nerve head (ONH) (inside disc), as well as in the peripapillary retina and macula were evaluated by comparing paired repeated observations using the median growth analysis.Results. In the tafluprost group there was a decrease in IOP by 19.4 % and an increase in PP by 8.7 % from the reference level. In the tafluprost/timolol group, these figures were 43 % and 30.1 %, respectively. OCT-A values did not change reliably, except for VD inside Disc: in the tafluprost group, the median growth was –2.28 (p = 0.02), for the tafluprost/ timolol group — –1.82 (p = 0.03). These changes were obtained in 11 patients of 12 in each group under treatment. In patients who did not receive treatment, all indicators remained unchanged.Conclusions. The results of this study showed a decrease in the density of the microcirculatory bed in the ONH in patients with initial glaucoma against the background of the tafluprost and tafluprost/timolol treatment, which can be explained by the restoration of autoregulation of the ocular blood flow in conditions of pronounced hypotensive drugs effect.