COMMENTARY

Brimonidine for Autoregulation in Normal-Tension Glaucoma

Shuchi B. Patel, MD

Disclosures

August 04, 2014

Effect of Brimonidine on Retinal Vascular Autoregulation and Short-term Visual Function in Normal Tension Glaucoma

Feke GT, Bex PJ, Taylor CP, et al.
Am J Ophthalmol. 2014;158:105-112.e1

Study Summary

The aim of this prospective, nonrandomized clinical trial was to assess whether brimonidine 0.15% alters retinal vascular autoregulation and short-term visual function in 46 patients with normal-tension glaucoma (NTG) who demonstrated retinal vascular dysregulation. These patients, who had not been previously treated with brimonidine, underwent retinal vascular autoregulation testing. In 23 patients, a change was found in retinal blood flow with posture changes of a magnitude that was outside the range previously found in healthy subjects. These patients were classified as having retinal vascular dysregulation and were included in the study. They were treated with brimonidine 0.15% for 8 weeks and were designated for retesting.

The 8-week course of brimonidine and retesting was completed by 17 patients, 14 of whom demonstrated a return of posture-induced retinal blood flow changes to levels consistent with normal retinal vascular autoregulation (P < .0001). There were no significant changes in frequency-doubling technology perimetry or in motion-detection parameters following treatment with brimonidine (P > .09 for all tests performed).

In conclusion, although brimonidine significantly improved retinal vascular autoregulation in patients with NTG, this did not translate to a short-term alteration in visual function.

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