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[Reduction of ocular pulse amplitude by apraclonidine--prospective double-blind, randomized clinical trial with 10
1Medizinisches Zentrum für Augenheilkunde der Philipps-Universität Marburg, Robert-Koch-Str. 4, 35037 Margurg.
Background:
The alpha-agonist Apraclonidin lowers effective intraocular pressure. Ischemia gains increasing importance in the pathogenesis of glaucoma. Therefore, an antiglaucomatous drug should also be investigated in regard of its influence on ocular hemodynamics.
Methods:
In a double masked, randomized, clinical trial 0.5% Apraclonidin eye drops were applied in 10 health subjects twice daily for 8 days. The control group (10 healty volunteers) received a placebo medication (0.9% NaCI) according to the same protocol. IOP, heart rate, blood pressure and ocular pulse amplitudes (OBF Labs, UK) were measured at baseline (1T0), 90 minutes after instillation of one eye drop (1T90), after 7 days of therapy (8T0) and again 90 minutes after an acute instillation (8T90). For statistical analysis the wilcoxon test for paried samples was used.
Results:
In Apraclonindin treated subjects IOP dropped significantly (P<0.01) from 15.6 mm Hg to 11.4/12.4/10.3 mm Hg (1T0/1T90/8T0/8T90. The control group showed a significant reduction at 1T90 (p + 0.01)and at 8T90 (p = 0.005) from 3.22 mm Hg to 2.48/31/2.35 mm Hg (1T0/1T90/8T0/8T90), in the control group the pulse amplitude remained constant.
Conclusion:
After one week of therapy with 0.5% Apralonidin, intraocular pressure dropped as expected in health volunteers. The observed reduction in pulse amplitudes in pulse amplitudes however could have a negative effect on long-term therapy in patients with chronic open-angle glaucoma .