Effects of Common Topical Glaucoma Therapy on Optic Nerve Head Blood Flow Autoregulation During Increased Arterial Blood Pressure and Artificially Elevated Intraocular Pressure in Healthy Humans

NCT ID: NCT00275756

Last Updated: 2014-11-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2008-09-30

Study Completion Date

2014-11-30

Brief Summary

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Background

Autoregulation is the ability of a vascular bed to maintain blood flow despite changes in perfusion pressure. The existence of an effective autoregulation in the optic nerve circulation has been shown in animals and humans. The exact mechanism behind this autoregulation is still unknown. The motive for the investigation of optic nerve head (ONH) blood flow autoregulation is to enhance the understanding of pathologic eye conditions associated with ocular vascular disorders. To clarify the regulatory mechanisms of ONH microcirculation is of critical importance to understand the pathophysiology of glaucoma, because there is evidence that glaucoma is associated with optic nerve head ischemia. Several studies indicate that a disturbed autoregulation might contribute to glaucomatous optic neuropathy. Currently, five classes of intraocular pressure (IOP) reducing drugs are available for topical therapy in patients with glaucoma or elevated intraocular pressure. These drugs have also vasoactive properties, which may influence both the resting ocular circulation and the autoregulatory mechanisms of blood flow during changes in ocular perfusion pressure.

Study objective

To investigate the influence of common topical glaucoma therapy on ONH blood flow regulation during changes in IOP and systemic arterial blood pressure.

Detailed Description

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Conditions

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Glaucoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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1

Group Type EXPERIMENTAL

Timolol (drug)

Intervention Type DRUG

Timolol (0.5%, non-selective beta-blocker, Timoptic®, Merck Sharp \& Dohme, Haarlem, Netherlands), dose 1 drop in one eye twice daily for two weeks

Laser Doppler flowmetry

Intervention Type DEVICE

blood flow measurements at the temporal neuroretinal rim of the optic nerve head, in total 4x 9 minutes on 2 study days

Goldmann applanation tonometer

Intervention Type DEVICE

intraocular pressure measurements, in total 2x 5 measurements on two study days

Suction cup method

Intervention Type PROCEDURE

The IOP will be raised by an 11 mm diameter, standardized suction cup placed on the temporal sclera with the anterior edge at least 1 mm from the limbus; 4x 8 minutes on 2 study days

2

Group Type EXPERIMENTAL

dorzolamide (drug)

Intervention Type DRUG

Dorzolamide (2%, carbonic anhydrase inhibitor, Trusopt®, Laboratoires Merck Sharp \& Dohme - Chibret, France), dose: 1 drop in one eye twice daily for two weeks

Laser Doppler flowmetry

Intervention Type DEVICE

blood flow measurements at the temporal neuroretinal rim of the optic nerve head, in total 4x 9 minutes on 2 study days

Goldmann applanation tonometer

Intervention Type DEVICE

intraocular pressure measurements, in total 2x 5 measurements on two study days

Suction cup method

Intervention Type PROCEDURE

The IOP will be raised by an 11 mm diameter, standardized suction cup placed on the temporal sclera with the anterior edge at least 1 mm from the limbus; 4x 8 minutes on 2 study days

3

Group Type EXPERIMENTAL

brimonidine (drug)

Intervention Type DRUG

Brimonidine (0.2%. alpha-2 adrenergic agonist, Alphagan®, Allergan Pharmaceuticals, Westport, Ireland), dose: 1 drop in one eye twice daily for two weeks

Laser Doppler flowmetry

Intervention Type DEVICE

blood flow measurements at the temporal neuroretinal rim of the optic nerve head, in total 4x 9 minutes on 2 study days

Goldmann applanation tonometer

Intervention Type DEVICE

intraocular pressure measurements, in total 2x 5 measurements on two study days

Suction cup method

Intervention Type PROCEDURE

The IOP will be raised by an 11 mm diameter, standardized suction cup placed on the temporal sclera with the anterior edge at least 1 mm from the limbus; 4x 8 minutes on 2 study days

Interventions

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Timolol (drug)

Timolol (0.5%, non-selective beta-blocker, Timoptic®, Merck Sharp \& Dohme, Haarlem, Netherlands), dose 1 drop in one eye twice daily for two weeks

Intervention Type DRUG

dorzolamide (drug)

Dorzolamide (2%, carbonic anhydrase inhibitor, Trusopt®, Laboratoires Merck Sharp \& Dohme - Chibret, France), dose: 1 drop in one eye twice daily for two weeks

Intervention Type DRUG

brimonidine (drug)

Brimonidine (0.2%. alpha-2 adrenergic agonist, Alphagan®, Allergan Pharmaceuticals, Westport, Ireland), dose: 1 drop in one eye twice daily for two weeks

Intervention Type DRUG

Laser Doppler flowmetry

blood flow measurements at the temporal neuroretinal rim of the optic nerve head, in total 4x 9 minutes on 2 study days

Intervention Type DEVICE

Goldmann applanation tonometer

intraocular pressure measurements, in total 2x 5 measurements on two study days

Intervention Type DEVICE

Suction cup method

The IOP will be raised by an 11 mm diameter, standardized suction cup placed on the temporal sclera with the anterior edge at least 1 mm from the limbus; 4x 8 minutes on 2 study days

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Men aged between 19 and 35 years, nonsmokers
* Body mass index between 15th and 85th percentile
* Normal findings in the medical history and physical examination unless the investigator considers an abnormality to be clinically irrelevant
* Normal ophthalmic findings, ametropia \< 1 Dpt.

Exclusion Criteria

* Regular use of medication, abuse of alcoholic beverages, participation in a clinical trial in the 3 weeks preceding the study
* Treatment in the previous 3 weeks with any drug
* Symptoms of a clinically relevant illness in the 3 weeks before the first study day
* Blood donation during the previous 3 weeks
* Presence of intraocular pathology: ocular hypertension, glaucoma, retinal vasculopathy or other retinal diseases
Minimum Eligible Age

19 Years

Maximum Eligible Age

35 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Medical University of Vienna

OTHER

Sponsor Role lead

Responsible Party

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Department of Clinical Pharmacology, Medical University of Vienna

Principal Investigators

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Gabriele Fuchsjaeger-Mayrl, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Clinical Pharmacology

Locations

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Department of Clinical Pharmacology

Vienna, , Austria

Site Status

Countries

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Austria

Other Identifiers

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OPHT-040106

Identifier Type: -

Identifier Source: org_study_id