Sustained perimacular vascular and visual response to topical beta blockers in normal human eyes

Making Basic Science Studies in Glaucoma More Clinically Relevant: The Need for a Consensus

Glaucoma is a chronic, progressive, and debilitating optic neuropathy that causes retinal damage and visual defects. The pathophysiologic mechanisms of glaucoma remain ill-defined, and there is an indisputable need for contributions from basic science researchers in defining pathways for translational research. However, glaucoma researchers today face significant challenges due to the lack of a map of integrated pathways from bench to bedside and the lack of consensus statements to guide in choosing the right research questions, techniques, and model systems. Here, we present the case for the development of such maps and consensus statements, which are critical for faster development of the most efficacious glaucoma therapy. We underscore that interrogating the preclinical path of both successful and unsuccessful clinical programs is essential to defining future research. One aspect of this is evaluation of available preclinical research tools. To begin this process, we highlight the utility of currently available animal models for glaucoma and emphasize that there is a particular need for models of glaucoma with normal intraocular pressure. In addition, we outline a series of discoveries from cell-based, animal, and translational research that begin to reveal a map of glaucoma from cell biology to physiology to disease pathology. Completion of these maps requires input and consensus from the global glaucoma research community. This article sets the stage by outlining various approaches to such a consensus. Together, these efforts will help accelerate basic science research, leading to discoveries with significant clinical impact for people with glaucoma.

The effect of ocular hypotensive agents on macula

We evaluated the effect of long-term topical antiglaucoma drugs on the macula using the noninvasive macular visual field threshold test in 100 eyes of 75 patients with ocular hypertension or primary open-angle glaucoma. We found that topical antiglaucoma agents can alter macular sensitivity after long-term therapy and advise evaluation of the macula in glaucoma patients receiving antiglaucomatous agents.

Retrobulbar haemodynamics and contrast sensitivity improvements after CO2 breathing

PURPOSE

Effects of gas mixtures have been widely studied. Carbon dioxide (CO(2)) is known to act as a vasodilator, whereas oxygen (O(2)) acts as a vasoconstrictor. Therefore, the interpretation of results is difficult. In this study, only the effect of an elevated CO(2) level on retrobulbar hemodynamics and contrast sensitivity was investigated.

METHODS

Thirty adults (age 31 +/- 7) were examined under normocapnic and hypercapnic conditions. Colour Doppler imaging was used to measure the velocity in the ophthalmic and central retinal artery. Moreover, contrast sensitivity using the CSV-1000 was investigated. Blood pressure, heart rate and intraocular pressure (IOP) were measured and ocular perfusion was calculated.

RESULTS

Under hypercapnia, mean end tidal CO(2) increased from 36.4 mmHg to 42.5 mmHg and blood oxygen saturation increased from 98.3% to 98.6% (p < 0.0001). Hypercapnia significantly reduced IOP by 0.94 mmHg (p < 0.0008). In the central retinal artery, the mean PSV increased by 18% (p < 0.0001) and the mean EDV by 21% (p = 0.0054). In the ophthalmic artery, the mean PSV increased by 13% (p < 0.0001) and the mean EDV by 26% (p = 0.0002). Furthermore, there was a significant increase of contrast sensitivity (spatial frequency: 3cpd: p = 0.0016; 6cpd: p = 0.005; 12cpd: p = 0.0012). Systolic blood pressure (p = 0.0225), mean arterial blood pressure (p = 0.0097) and ocular perfusion pressure (p = 0.0013) increased significantly.

CONCLUSION

This setting was able to detect an increase in blood flow velocity in normal subjects under hypercapnia. Furthermore, hypercapnia results in a functional improvement in contrast sensitivity, possible due to the increased blood flow or the increase in blood oxygen levels.