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Klin Monbl Augenheilkd 2001; 218(3): 187-191
DOI: 10.1055/s-2001-13079
KLINISCHE STUDIE

Georg Thieme Verlag Stuttgart · New York

Reduktion der okulären Pulsamplitude unter Apraclonidin - prospektive doppelt maskierte Studie an 10 Probanden[1]

Reduction of ocular pulse amplitude as effect of Apraclonidin - prospective double masked, randomized clinical trial in 10 subjectsGabriele  B. Kuba, Patricia Austermann
  • Medizinisches Zentrum für Augenheilkunde der Philipps-Universität Marburg, Robert-Koch-Str. 4, 35037 Marburg
  • (geschäftsführender Direktor: Prof. Dr. P. Kroll)
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Publication History

Publication Date:
31 December 2001 (online)

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Zusammenfassung

Hintergrund Die effektive augeninnendrucksenkende Wirkung des α-Agonisten Apraclonidin ist hinreichend bekannt. Da jedoch Perfusionsstörungen in der Pathogenese der primären Offenwinkelglaukome zunehmend an Bedeutung gewinnen, sollte ein antiglaukomatöses Medikament auch hinsichtlich seiner Auswirkung auf die okuläre Zirkulation beurteilt werden.

Methode In einer prospektiven doppelt maskierten Studie applizierten 10 Probanden 0,5 % Apraclonidin-AT, und 10 Probanden Plazebo-AT (0,9 % NaCl), 2 × täglich für 8 Tage. IOD, Puls, Blutdruck und okuläre Pulsamplituden (OBF Labs, UK) wurden initial (1T0), 90 min nach Tropfapplikation (1T90), nach 7-tägiger Therapie (8T0) und nach erneuter Tropfapplikation (8T90) gemessen. Die statistische Auswertung erfolgte mit dem Wilcoxon-Test für verbundene Stichproben.

Ergebnisse In der Apraclonidin-Gruppe sank der IOD signifikant (p < 0,01) von 15,6 mm Hg auf 11,4/12,4/10,3 mm Hg (1T0/1T90/8T0/8T90). In der Kontrollgruppe zeigte sich ein Abfall zu 8T0 (p = 0,02). Der Blutdruck blieb in beiden Gruppen konstant, der Puls zeigte in der Kontrollgruppe zu 1T90 einen Abfall. Die Pulsamplitude fiel in der Apraclonidin-Gruppe zu 1T90 (p = 0,01) und zu 8T90 (p = 0,005) signifikant von 3,22 mm Hg auf 2,48/3,1/2,35 mm Hg (1T0/1T90/8T0/8T90) und blieb in der Kontrollgruppe unverändert.

Schlussfolgerung Während einer 1-wöchigen Therapie mit 0,5 % Apraclonidin kam es erwartungsgemäß zu einem signifikanten Abfall des Augeninnendruckes bei gesunden Probanden. Die beobachtete Reduktion der okulären Pulsamplituden könnte sich jedoch in der Langzeittherapie bei Patienten mit chronischem Offenwinkelglaukom ungünstig auswirken.

Background The α-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 healthy subjects twice daily for 8 days. The control group (10 healthy volunteers) received a placebo medication (0.9 % NaCl) 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 paired samples was used.

Results In Apraclonidin 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 drop at 8T0 (p = 0.02). The blood pressure remained constant in both groups, the heart rate showed a drop in the control group at 1T90. In Apraclonidin treated subjects the pulse amplitude showed a significant reduction at 1T90 (p = 0.01) and at 8T90 (p = 0.005) from 3.22 mm Hg to 2.48/3.1/2.35 mm Hg (1T0/1T90/8T0/8T90), in the control group the pulse amplitude remained constant.

Conclusion After one week of therapy with 0.5 % Apraclonidin, intraocular pressure dropped as expected in healthy volunteers. The observed reduction in pulse amplitudes however could have a negative effect on long-term therapy in patients with chronic open-angle glaucoma.

Schlüsselwörter

Apraclonidin - chronisches Offenwinkelglaukom - Glaukomtherapie - okuläre Hämodynamik - okuläre Pulsamplitude

Key words

Apraclonidin - chronic open-angle glaucoma - glaucoma therapy - ocluar hemodynamics - ocular pulse amplitude

01 1 Manuskript erstmalig eingereicht am 9. 6. 00 und in der vorliegenden Form angenommen am 11. 8. 00.

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