Abstract
Purpose: The effect of topical levobunolol HCl 0.5% on the retinal circulation was studied on 15 normal volunteers aged 21-54 years (32 ± 10 years).
Methods: In a double-masked, randomised design, one eye of each subject received a drop of levobunolol HCl 0.5% (LEV) and the fellow eye received a drop of artificial tears (TEAR). Leucocyte velocity (VBFS) and density in the retinal macular microcirculation were measured by the blue-field simulation technique. Venous diameter (D), maximum erythrocyte velocity (Vmax) and volumetric blood flow rate (Q) were measured in a major temporal vein by laser Doppler velocimetry and monochromatic fundus photography.
Results: The following average changes from baseline were observed 2 hours after treatment: heart rate, −4.6 ± 8.3% (p = 0.04); intraocular pressure, −31.7 10.6% (p = 0.0001); and perfusion pressure, 15.4 14.4% (p = 0.02) in LEV eyes; no statistically dgnificant changes in IOP and perfusion pressure were seen in TEAR eyes. When each eye was compared with its own baseline, there were no significant changes in VBFS, density, D, Vmax and Q in LEV eyes. In TEAR eyes, there were no significant changes in VBFS, density, Vmax and Q, but a significant change in D (−1.8 ± 2.6%; P = 0.02) was observed. A significant average percentage increase in Q of 10.9 ± 19.2% (paired t-test between the change after LEV and the Aange after TEAR, p = 0.044) was seen in LEV eyes when compared with TEAR eyes. Twelve of the 15 subjest demonstrated a relative increase in Q in the LEV eyes in comparison with the TEAR eyes, while 3 subjects showed the opposite.
Conclusion: A significant difference in the effect of levobunolol between the two eyes was detected, even though there was no statistically significant effect when each eye was compared with its baseline.
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References
Brooks AM, Gillies WE . Ocular beta-blockers in glaucoma management: clinical pharmacological aspects. Drugs Aging 1992;2:208–21.
Grunwald JE . Effect of timolol on human retinal circulation. Invest Ophthalmol Vis Sci 1986;27:1713–9.
Grunwald JE . Effect of two weeks of timolol maleate treatment on the normal retinal circulation. Invest Ophthalmol Vis Sci 1991;32:39–45.
Grunwald JE . Effect of timolol maleate on the retinal circulation of human eyes with ocular hypertension. Invest Ophthalmol Vis Sci 1990;31:521–6.
Yoshida A, Feke GT, Ogasawara H, Goger DG, Murray DL, McMeel W . Effect of timolol on human retinal, choroidal and optic nerve head circulation. Ophthalmic Res 1991;23:162–70.
Schulte K, Wolf S, Werner E, Remky A, Arend O, Reim M . Effect of metipranolol on the retinal circulation in humans. Invest Ophthalmol Vis Sci 1992;33(Suppl):1078.
Weber GRJ . Der Eisfluss der Betablocker timolol und pindolol auf die retinale Hemodynamik:eine videoan-giographische Studie. Klin Monatsbl Augenheilkd 1987;190:34–9.
Wolf S, Arend O, Sponsel WE, Schulte K, Cantor LB, Reim M . Retinal hemodynamics using scanning laser ophthalmoscopy and hemorrheology in chronic open-angle glaucoma. Ophthalmology 1993;100:1561–6.
Kolker AE, Hetherington J . In: Becker-Schaffer's diagnosis and therapy of the glaucomas. St Louis: CV Mosby, 1983:245.
Grunwald JE, Zinn H . The acute effect of oral acetazolamide on macular blood flow. Invest Ophthalmol Vis Sci 1992;33:504–7.
Riva CE, Grunwald JE, Sinclair SH, Petrig BL . Blood velocity and volumetric flow rate in human retinal vessels. Invest Ophthalmol Vis Sci 1985;26:1124–32.
Riva CE, Feke CT . Laser Doppler velocimetry in the measurement of retinal blood flow. In: Goldman L, editor. The biomedical laser: technology and clinical applications. New York: Springer, 1981:135–61.
Damon DN, Duling BR . A comparison between mean blood velocities and center-line red cell velocities as measured with a mechanical image streaking veloci-meter. Microvasc Res 1979;17:330–2.
Salminen L . Review: Systemic absorption of topically applied ocular drugs in humans. J Ocul Pharmacol 1990;6:243–9.
Robinson F, Petrig BL, Sinclair SH, Riva CE, Grunwald JE . Does topical phenylephrine, tropica-mide, or proparacaine affect macular blood flow? Ophthalmology 1985;92:1130–2.
Grunwald JE, Delehante J . Effect of topical carteolol on the normal human retinal circulation. Invest Ophthalmol Vis Sci 1992;33:1853–6.
Friedlander S, DeMaio R, Sinclair S, Werner E . The acute effects of betaxolol on human macular hemody-namics in normals. Invest Ophthalmol Vis Sci 1992;33(Suppl):810.
Piltz JR, Bose S . Effect of beta1-selective and non-selective beta blockers on macular blood flow and contrast sensitivity. Invest Ophthalmol Vis Sci 1994;35(Suppl):1659.
Burgoyne JE, Harris A, Shoemaker JA, Weinland M, Phillips C, Cantor LB, et al. Perimacular hemodynamic effects of betaxolol, carteolol and levobunolol. Invest Ophthalmol Vis Sci 1994;35(Suppl):1388.
Chen S, Robinson F, Petrig BL, Grunwald JE, Riva CE . The acute effect of topical timolol on human macular capillary blood flow. Invest Ophthalmol Vis Sci 1993;34(Suppl):1394.
Colton T . In: Statistics in medicine. Boston: Little, Brown, 1974:134.
Sears ML . Autonomic nervous system: adrenergic agonists. In: Sears ML, editor. Pharmacology of the eye. Berlin: Springer, 1984:206.
Alm A, Bill A . The oxygen supply to the retina. II. Effects of high intraocular pressure and of increased arterial carbon dioxide tension on uveal and retinal blood flow in rats. A study with radioactively labelled microspheres including flow determinations in brain and some other tissues. Acta Physiol Scand 1972;84:306–19.
Geijer C, Bill A . Effects of raised intraocular pressure on retinal, prelaminar, laminar, and retrolaminar optic nerve flow in monkeys. Invest Ophthalmol Vis Sci 1979;18:1030–42.
Riva CE, Sinclair SH, Grunwald JE . Autoregulation of retinal circulation in response to decrease of perfusion pressure. Invest Ophthalmol Vis Sci 1981;21:34–8.
Grunwald JE, Sinclair SH, Riva CE . Autoregulation of the retinal circulation in response to decrease of intraocular pressure below normal. Invest Ophthalmol Vis Sci 1982;23:124–7.
Forster BA, Ferrari-Dileo G, Anderson D . Adrenergic alpha1 and alpha2 binding sites are present in bovine retinal blood vessels. Invest Ophthalmol Vis Sci 1987;28:1741–6.
Ferrari-Dileo G . Beta1 and beta2 adrenergic binding sites in bovine retina and retinal blood vessels. Invest Ophthalmol Vis Sci 1988;29:695–9.
Hoste AM, Boels PJ, Brutsaert DL, deLaey JJ . Effect of alphai and beta agonists on contraction of bovine retinal resistance arteries in vitro. Invest Ophthalmol Vis Sci 1989;30:44–50.
Busch MJ, Stjernschantz J, Hoyng PF . Increase in ocular blood flow induced by isobutylmethylxanthine and epinephrine. Exp Eye Res 1991;52:199–204.
Menom IA, Wakeham DC, Persad GD, Avaria M, Trope GE, Baeu PK . Quantitative determination of the melanin contents in ocular tissues from human blue and brown eyes. J Ocul Pharmacol 1992;6:35–42.
Nagata A, Mishima HK, Kiuchi Y, Hirota A, Kur-okawa T, Ishibashi S . Binding of antiglaucomatous drugs to synthetic melanin and their hypotensive effects on pigmented and non-pigmented rabbit eyes. Jpn J Ophthalmol 1993;37:32–8.
Salminen L, Imre G, Huupponen R . The effect of ocular pigmentation on intraocular pressure response to timolol. Acta Ophthalmol Suppl (Copenh) 1985;173:15–8.
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Leung, M., Grunwald, J. Short-term effects of topical levobunolol on the human retinal circulation. Eye 11, 371–376 (1997). https://doi.org/10.1038/eye.1997.78
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DOI: https://doi.org/10.1038/eye.1997.78
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