Abstract
Purpose
To evaluate the effect of latanoprost 0.005% on the optic nerve head (ONH) and retinal circulation of newly diagnosed and previously untreated primary open-angle glaucoma (POAG) patients.
Methods
Twenty-two newly diagnosed and previously untreated POAG patients (mean age±SD: 68.38±11.92 years) were included in this longitudinal open-label study. Patients were treated with latanoprost 0.005% once a day. Intraocular pressure (IOP), systemic blood pressure (BP), mean ocular perfusion pressure (MOPP), and ocular perfusion parameters ‘volume’, ‘velocity’, and ‘flow’ measured at the optic nerve head (ONH) and retina by means of Heidelberg Retina Flowmeter system were evaluated during a 6-month follow-up period.
Results
Treatment with latanoprost 0.005% resulted in a significant decrease in IOP (P<0.0001) and increase in MOPP (P<0.0001). After correcting for changes in MOPP, the blood velocity measured at the ONH level was significantly higher after 6 months of treatment than at baseline (P=0.0310). In addition, blood volume and flow measured at the peripapillary retina level improved after 3 and 6 months of treatment (P=0.0170; P=0.0260, and P=0.0170; P=0.0240 respectively).
Conclusion
Previously untreated POAG patients exhibit reduced IOP, increased MOPP and improved ocular perfusion at the ONH and retina levels when treated with Latanoprost 0.005%. These effects could be beneficial for glaucoma patients suffering from ocular vascular dysregulation.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Rojanapongpun P, Drance SM, Morrison BJ . Ophthalmic artery flow velocity in glaucomatous and normal subjects. Br J Ophthalmol 1993; 77: 25–29.
Plange N, Kaup M, Arend O, Remky A . Asymmetric visual field loss and retrobulbar haemodynamics in primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2006; 244(8): 978–983.
Nicolela MT, Hnik P, Drance SM . Scanning laser Doppler flowmeter study of retinal and optic disk blood flow in glaucomatous patients. Am J Ophthalmol 1996; 122: 775–783.
Kaiser HJ, Schötzau A, Stümpfig D, Flammer J . Blood-flow velocities of the extraocular vessels in patients with high-tension and normal-tension primary open-angle glaucoma. Am J Ophthalmol 1997; 123: 320–327.
Butt Z, O'Brien C, McKillop G, Aspinall P, Allan P . Color Doppler imaging in untreated high- and normal-pressure open-angle glaucoma. Invest Ophthalmol Vis Sci 1997; 38: 690–696.
Findl O, Rainer G, Dallinger S, Dorner G, Polak K, Kiss B et al. Assessment of optic disk blood flow in patients with open-angle glaucoma [In Process Citation]. Am J Ophthalmol 2000; 130: 589–596.
Gherghel D, Orgül S, Gugleta K, Gekkieva M, Flammer J . Relationship between ocular perfusion pressure and retrobulbar circulation in glaucoma patients with progressive damage. Am J Ophthalmol 2000; 130: 597–605.
Sogano S, Tomita G, Kitazawa Y . Changes in retinal nerve fiber layer thickness after reduction of intraocular pressure in chronic open-angle glaucoma. Ophthalmology 1993; 100: 1253–1258.
Emre M, Orgul S, Gugleta K, Flammer J . Ocular blood flow alteration in glaucoma is related to systemic vascular dysregulation. Br J Ophthalmol 2004; 88: 662–666.
Susanna R, Basseto FL . Hemorrhage of the optic disc and neurosensorial dysacousia. J Glaucoma 1992; 1: 248–253.
Kaiser HJ, Flammer J, Graf T, Stümpfig D . Systemic blood pressure in glaucoma patients. Graefe's Arch Clin Exp Ophthalmol 1993; 231: 677–680.
Kaiser HJ, Flammer J, Burckhardt D . Silent myocardial ischemia in glaucoma patients. Ophthalmologica 1993; 207: 6–7.
Bechetoille A, Bresson-Dumont H . Diurnal and nocturnal blood pressure drops in patients with focal ischemic glaucoma. Graefe's Arch Clin Exp Ophthalmol 1994; 232: 675–679.
Weinstein JM, Funsch D, Page RB, Brennan RW . Optic nerve blood flow and its regulation. Invest Ophthalmol Vis Sci 1982; 23: 640–645.
Graham SL, Drance SM, Wijsman K, Douglas GR, Mikelberg FS . Ambulatory blood pressure monitoring in glaucoma. The nocturnal dip. Ophthalmology 1995; 102: 61–69.
Stroman GA, Stewart WC, Golnik KC, Cure JK, Olinger RE . Magnetic resonance imaging in patients with low-tension glaucoma. Arch Ophthalmol 1995; 113: 168–172.
Waldmann E, Gasser P, Dubler B, Huber C, Flammer J . Silent myocardial ischemia in glaucoma and cataract patients. Graefe's Arch Clin Exp Ophthalmol 1996; 234: 595–598.
O'Brien C, Butt Z . Blood flow velocity in the peripheral circulation in glaucoma patients. Ophthalmologica 1999; 213: 150–153.
Kashiwagi K, Tsumura T, Ishii H, Ijiri H, Tamura K, Tsukahara S . Circadian rhythm of autonomic nervous function in patients with normal-tension glaucoma compared with normal subjects using ambulatory electrocardiography. J Glaucoma 2000; 9: 239–246.
Kashiwagi K, Hosaka O, Kashiwagi F, Taguchi K, Mokiyuki J, Ishii H et al. Systemic circulatory parameters: comparison between patients with normal tension glaucoma and normal subject using ambulatory monitoring. Jpn J Ophthalmol 2001; 45: 388–396.
Harris A, Spaeth GL, Sergott RC, Katz LJ, Cantor LB, Martin BJ . Retrobulbar arterial hemodynamic effects of betaxolol and timolol in normal-tension glaucoma. Am J Ophthalmol 1995; 120: 168–175.
Yoshida A, Ogasawara H, Fujio N, Konno S, Ishiko S, Kitaya N et al. Comparison of short- and long-term effects of betaxolol and timolol on human retinal circulation. Eye 1998; 12: 848–853.
Sponsel WA, Terry S, Khuu HD, Lam KW, Frenzel H . Periocular accumulation of timolol and betaxolol in glaucoma patients under long-term therapy. Surv Ophthalmol 1999; 43(Suppl): S210–S213.
Bergstrand IC, Heijl A, Wollmer P, Hansen F, Harris A . Timolol increases retrobulbar flow velocities in untreated glaucoma eyes but not in ocular hypertension. Acta Ophthalmol Scand 2001; 79: 455461.
Vetrugno M, Maino A, Cantatore F, Ruggeri G, Cardia L . Acute and chronic effects of brimonidine 0 2 on intraocular pressure and pulsatile ocular blood flow in patients with primary open-angle glaucoma: an open-label, uncontrolled, prospective study. Clin Ther 2001; 23: 1519–1528.
Martinez A, Gonzales F, Capeans C, Perez R, Sanchez-Salorio M . Dorzolamide effect on ocular blod flow. Invest Ophthalmol Vis Sci 1999; 40: 1270–1275.
Harris A, Arend O, Kagemann L, Garrett M, Chung HS, Martin B . Dorzolamide, visual function and ocular hemodynamics in. J Ocul Pharmacol Ther 1999; 15: 189–197.
Bernd AS, Pillunat LE, Bohm AG, Schmidt KG, Richard G . Ocular hemodynamics and visual field in glaucoma treated with dorzolamide. Ophthalmologe 2001; 98: 451–455.
Galassi F, Sodi A, Renieri G, Ucci F, Pieri B, Harris A et al. Effects of timolol and dorzolamide on retrobulbar hemodynamics in patients with newly diagnosed primary open-angle glaucoma. Ophthalmologica 2002; 216: 123–128.
Ishii K, Tomidokoro A, Nagahara M, Tamaki Y, Kanno M, Fukaya Y et al. Effects of topical latanoprost on optic nerve head circulation in rabbits, monkeys and humans. Invest Ophthalmol Vis Sci 2001; 42: 2957–2963.
Tamaki Y, Nagahara M, Araie M, Tomita K, Sandoh S, Tomidokoro A . Topical latanoprost and optic nerve head and retinal circulation in humans. J Ocular Pharmacol Therap 2001; 17: 403–411.
Vetrugno M, Cantatore F, Gigante G, Cardia L . Latanoprost 0.005% in POAG: effects on IOP and ocular blood flow. Acta Ophthalmol Scand Suppl 1998; 227: 40–41.
McKibbin M, Menage MJ . The effect of once-daily latanoprost an intraocular pressure and pulsatile ocular blood flow in normal tension glaucoma. Eye 1999; 13: 31–34.
Geyer O, Man O, Weintraub M, Silver DM . Acute effect of latanoprost on pulsatile ocular blood flow in normal eyes. Am J Ophthalmol 2001; 131: 198–202.
Georgopoulos GT, Diestelhorst M, Fisher R, Ruokonen P, Krieglstein GK . The short-term effect of latanoprost on intraocular pressure and pulstatile ocular blood flow. Acta Ophthalmol Scand 2002; 80: 54–58.
Michelson G, Schmauss B . Two dimensional mapping of the perfusion of the retina and optic nerve head. Br J Ophthalmol 1995; 79: 1126–1132.
Michelson G, Langhans MJ, Groh MJ . Clinical investigation of the combination of a scanning laser ophthalmoscope and laser Doppler flowmeter. Ger J Ophthalmol 1995; 4: 342–349.
Burk RO, Rohrschneider K, Noack H, Volcker HE . Are large optic nerve heads susceptible to glaucomatous damage at normal intraocular pressure? A three-dimensional study by laser scanning tomography. Graefe's Arch Clin Exp Ophthalmol 1992; 230: 552–560.
Burk RO, Rohrschneider K, Takamoto T, Volcker HE, Schwartz B . Laser scanning tomography and stereophotogrammetry in three-dimensional optic disc analysis. Graefe's Arch Clin Exp Ophthalmol 1993; 231: 193–198.
Rohrschneider K, Burk RO, Volcker HE . Reproducibility of topometric data acquisition in normal and glaucomatous optic nerve heads with the laser tomographic scanner. Graefe's Arch Clin Exp Ophthalmol 1993; 231: 457–464.
Bartz-Schmidt KU, Weber J, Heimann K . Validity of two dimensional data obtained with the Heidelberg retina tomograph as verified by direct measurements in normal optic nerve heads. Ger J Ophthalmol 1994; 3: 400–405.
Iester M, Mikelberg FS, Drance SM . The effect of optic disc size on diagnostic precision with the Heidelberg Retina Tomograph. Ophthalmology 1997; 104: 545–548.
Iester M, Broadway DC, Mikelberg FS, Drance SM . A comparison of healthy, ocular hypertensive, and glaucomatous optic disc topographic parameters. J Glaucoma 1997; 6: 363–370.
Jonescu-Cuypers CP, Thumann G, Hilgers RD, Batz-Schmidt KU, Krott R, Krieglstein GK . Long-term fluctuations of the normalised rim/disc area ratio quotient in normal eyes. Graefe's Arch Clin Exp Ophthalmol 1999; 237: 181–186.
Weinreb RN, Lusky M, Bartsch DU, Morsman D . Effect of repetitive imaging on topographic measurements of the optic nerve head. Arch Ophthalmol 1993; 111: 636–638.
Saruhan A, Orgul S, Kocak I, Prunte C, Flammer J . Descriptive information of topographic parameters computed at the optic nerve head with the Heidelberg retina tomograph. J Glaucoma 1998; 7: 420–429.
Jonescu-Cuypers CP, Chung HS, Kagemenn L, Ishii Y, Zarfati D, Harris A . New neuroretinal rim blood flow evaluation method combining Heidelberg retina flowmetry and tomography. Br J Ophthalmol 2001; 85: 304–309.
Kagemann L, Harris A, Chung HS, Evans D, Buck S, Martin B . Heidelberg retinal flowmetry: factors affecting blood flow measurement. Br J Ophthalmol 1998; 82: 131–136.
Hosking SL, Embleton S, Cunliffe IA . Application of a local search strategy improves the detection of blood flow deficits in the neuroretinal rim of glaucoma patients using scanning laser Doppler flowmetry. Br J Ophthalmol 2001; 85: 1298–1302.
Sehi M, Flanagan JG . The effect of image alignement on capillary blood flow measurement of the neuroretinal rim using the Heidelberg retina flowmeter. Br J Ophthalmol 2004; 88: 204–206.
Alm A, Villumsen J, Tornquist P, Mandahl A, Airaksinen J, Tuulonen A et al. Intraocular pressure-reducing effect of PhXA41 in patients with increased eye pressure. A one-month study [see comments]. Ophthalmology 1993; 100: 1312–1316.
Camras CB . The United States Latanoprost Study Group: Comparison of latanoprost and timolol in patients with ocular hypertension and glaucoma: a six-month masked, multicenter trial in the United States. Ophthalmology 1996; 103: 138–147.
Drance SM, Crichton A, Mills RP . Comparison of the effect of latanoprost 0.005% and timolol 0.5% on the calculated ocular perfusion pressure in patients with normal-tension glaucoma. Am J Ophthalmol 1998; 125: 585–592.
Liu CJ, Ko YC, Cheng CY, Chou JC, Hsu WM, Liu JH . Effect of latanoprost 0.005% and brimonidine tartrate 0.2% on pulsatile ocular blood flow in normal tension glaucoma. Br J Ophthalmol 2002; 86: 1236–1239.
Liu CJ, Ko YC, Cheng CY, Chiu AW, Chou JC, Hsu WM et al. Changes in intraocular pressure and ocular perfusion pressure after latanoprost 0.005 or brimonidine tartrate 0.2% in normal-tension glaucoma patients. Ophthalmology 2002; 109: 2241–2247.
Sugiyama K, Bacon DR, Cioffi GA, Fahrenback WH, Van Buskirk EM . The effects of phenylephrine on the ciliary body and optic nerve head microvasculature in rabbits. J Glaucoma 1992; 1: 156–164.
Inan UU, Ermis SS, Yucel A, Ozturk F . The effects of latanoprost and brimonidine on blood flow velocities of the retrobulbar vessels a 3-month clinical trial. Acta Ophthalmol Scand 2003; 81: 155–160.
Erkin EF, Tarhan S, Kaykcioglu OR, Devici H, Guler C, Goktan C . Effects of betaxolol and latanoprost on ocular blood flow and visual field in patients with primary open-angle glaucoma. Eur J Ophthalmol 2004; 14: 211–219.
Kaley G, Hintze TH, Panenbeck M, Messina EJ . Role of prostaglandins in microcirculatory function. Adv Prostaglandin Thromboxane Leukot Res 1985; 13: 27–35.
Astin M, Stjernschantz J, Selen G . Role of nitric oxide in PGF2 alpha-induced ocular hyperemia. Exp Eye Res 1994; 59: 401–407.
Stjernschantz J, Selen G, Astin M, Resul B . Microvascular affects of selective prostaglandin analogues in the eye with special reference to latanoprost and glaucoma treatment. Prog Ret Eye Res 2000; 19: 459–496.
Michelson G, Schmauss B, Langhans MJ, Harazny J, Groh MJM . Principle, validity, and reliability of scanning laser Doppler flowmetry. J Glaucoma 1996; 5: 99–105.
Chauhan BC, Smith FM . Confocal scanning laser Doppler flowmetryexperiments in a model flow system. J Glaucoma 1997; 6: 237–245.
Bohdanecka Z, Orgul S, Prunte C, Flammer J . Influence of acquisition parameters on hemodynamic measurements with the Heidelberg Retina Flowmeter at the optic disc. J Glaucoma 1998; 7: 151–157.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gherghel, D., Hosking, S., Cunliffe, I. et al. First-line therapy with latanoprost 0.005% results in improved ocular circulation in newly diagnosed primary open-angle glaucoma patients: a prospective, 6-month, open-label study. Eye 22, 363–369 (2008). https://doi.org/10.1038/sj.eye.6702639
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.eye.6702639
Keywords
This article is cited by
-
Effects of antiglaucoma drugs on blood flow of optic nerve heads and related structures
Japanese Journal of Ophthalmology (2013)
