Evaluation of treatment response with color doppler ultrasonography in cases with primary open-angle glaucoma

Abstract

Aims: Beta-blockers, the most frequently preferred drug group in glaucoma.Withcolor Doppler ultrasonography (CDU), the localization of retrobulbar vascular structures, their flow rates and directions, and the effects of the drugs used on the ocular circulation can be examined in a dynamic, reliable, and noninvasive way in less time than other techniques. The aim of our study was to compare the effects of beta-blockers, widely used in glaucoma treatment, and the additional neuroprotectant flunarizine on ocular hemodynamics using CDU. Methods: Between November 1998 and August 1999, 30 cases diagnosed with POAG in the GlaucomaUnit of the 1st EyeClinic of our center were included in the study. Patients were divided into 3 groups according to their beta-blocker treatment. Patients' CDU examinations were then examined by an experience dradiologist, and peaksys to lic flow velocity (PSFV) and end-diastolic flow velocity (EDFV) of the ophthalmicartery (OA), central retinal artery (CRA), and lateral (temporal) posterior ciliary arteries (LPCA) in the right or left eye were detected. Results: Of the 30 patients who participated in the study, 14 were male and 16 were female. Nine patients had hypertension (HT), 3 patients had diabetes (DM), and 6 patients had migraine. The mean age was similar in all three groups. There was a significant reduction in IOP in all three patient groups in whom IOP was measured after the use of topical beta-blockers (P<0.01). The use of flunarizine had no effect on IOP in all three groups (P>0.05). There was no statistically significant difference between groups in OA PSFVs and EDFVs at the first, second, and third measurements using the three beta-blockers (P>0.05). No statistically significant difference existed between all three groups in the measurements of CRAPSFVs and EDFVs (P>0.05). There were also no significant differences between groups in measurements of LPCA, PSFVs, and EDFVs at baseline and follow-up (P>0.05). Conclusion: We found that the changes in hemodynamic parameters and reduction in IOP with all three beta-blockers were similar on color Doppler USG in patients using beta-blockers for the treatment of glaucoma. We observed that flunarizine had no effect on systemic hemodynamic parameters, did not affect IOP, and had no adverse effects on retrobulbar hemodynamic parameters when combined with beta-blockers. Local beta-blockers remain the mainstay of medical treatment for POAG because of their low systemic side effects and beneficial effects on the eye.