Abstract
Purpose To determine the acute effects of application of 2% pilocarpine on pulsatile ocular blood flow.
Methods In a randomised prospective controlled study of an exploratory nature, 18 subjects with ocular hypertension had pilocarpine 2% eye drops instilled into a randomly chosen eye three times at 10 min intervals. Physiological saline was instilled into the contralateral control eye. Intraocular pressure (IOP) and pulsatile ocular blood flow (POBF) measurements were taken before the first application and 90 min after the last application using the OBF tonometer (OBF Laboratory, Wilts, UK). Statistical analysis was performed using the Wilcoxon signed rank test.
Results Of the 18 patients who entered the trial, 2 were suggested by the OBF system software as having ‘poorly reliable’ data. The analysis was made on the remaining 16. There was a significant reduction in IOP at 90 min for the treated eye in comparison with the contralateral control eye (p = 0.001; median difference -4.25 mmHg; 95% confidence interval, -5.85 to -2.40). There was a significant increase in POBF at 90 min in the treated eye in comparison with the contralateral control eye (p < 0.001; median difference 4.60 µl/s; 95% confidence interval, 2.35 to 6.75).
Conclusion Acute application of pilocarpine 2% drops increased POBF to a significant extent in untreated ocular hypertension.
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Tielsch JM, Katz J, Sommer A, Quigley HA, Javitt JC . Hypertension, perfusion pressure and primary open glaucoma: a population based assessment. Arch Ophthalmol 1995;113:216–21.
Butt Z, O'Briens C . Reproducibility of pulsatile ocular blood flow measurement. J Glaucoma 1995;4:214–8.
Carenini AB, Brogliatti B, Gugliermina P, Rolle T . Flusso ematico oculare. Boll Ocul 1992;71(Suppl 4 ):3–63.
Schmidt KG, Stegman DY, Serie JB, et al. Ocular pulse amplitude in primary open angle glaucoma, low tension glaucoma, and in ocular hypertension patients before and after topical drug treatment. Invest Ophthalmol Vis Sci 1991;32(Suppl):943.
Schmidt KG, Ruckmann A, Pillunat LE . Topical carbonic anhydrase inhibitor increases ocular pulse amplitude in high tension primary open angle glaucoma. Br J Ophthalmol 1998;82:758–62.
Williamson TH, Harris A . Ocular blood flow measurement. Br J Ophthalmol 1994;78:939–45.
Bron AJ, Tripathi RC, Tripathi BJ . Wolff's anatomy of the eye and orbit, 8th ed. London: Chapman and Hall Medical, 1998.
Bill A . Autonomic nervous control of uveal blood flow. Acta Physiol Scand 1962;56:70–81.
Alm A, Bill A, Young FA . The effects of pilocarpine and neostigmine on blood flow through anterior uvea in monkeys: a study with radioactively labelled microspheres. Exp Eye Res 1973;15:31–6.
German EJ, Hurst MA, Wood D . Ocular blood flow variations with use of clinical ocular antimuscarinic agents. The second international symposium on experimental and clinical ocular pharmacology and pharmaceutics, Munich, 1997.
Sendelbeck L, Moore D, Urquhart J . Comparative distribution of pilocarpine in ocular tissues of the rabbit during administration by eye drop or by membrane-controlled delivery systems. Am J Ophthalmol 1975;80:274–83.
Chiou G, Chen YJ . Effects of antiglaucoma drugs on ocular blood flow inocular hypertensive rabbits. J Ocul Pharmacol 1993;9:13–24.
Van Hoose MC, Leaders FE . The role of cornea in the biologic response to pilocarpine. Invest Ophthalmol 1974;3:377.
Harris LS, Galin MA . Dose-response analysis of pilocarpine induced ocular hypotension. Am J Ophthalmol 1970;84:605.
Trew DR, Smith SE . Postural studies in pulsatile ocular blood flow. II. Chronic open angle glaucoma. Br J Ophthalmol 1991;75:71–5.
Claridge KG . The effect of topical pilocarpine on ocular blood flow. Eye 1993;7:507–10.
Brodway DC, Drance SM . Glaucoma and vasospasm. Br J Ophthalmol 1998;82:862–70.
Langham ME, Romeiko WJ . The unfavourable action of timolol on ocular blood flow and vision in glaucomatous eyes [abstract]. Invest Ophthalmol Vis Sci 1992;32(Suppl):1046.
Martin XD, Rabineau PA . Vasoconstrictive effect of topical timolol on human retinal arteries [see comments]. Graefes Arch Clin Exp Ophthalmol 1989;227:526–30.
James CB . Pulsatile ocular blood flow [editorial]. Br J Ophthalmol 1998;82:720–1.
Sossi N, Anderson DR . Effect of elevated intraocular pressure on blood flow. Arch Ophthalmol 1983;101:98–101.
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Shaikh, M., Mars, J. The acute effect of pilocarpine on pulsatile ocular blood flow in ocular hypertension. Eye 15, 63–66 (2001). https://doi.org/10.1038/eye.2001.15
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DOI: https://doi.org/10.1038/eye.2001.15
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