Effect of radical scavengers on ocular hemodynamics and on the visual field in primary open angle glaucoma

Purpose: Beside an increased intraocular pressure an impaired blood supply of the optic nerve has to be regarded as one of the main pathogenic factors in the development of glaucomatous optic nerve head atrophy. Because radical scavengers seem to be effective in the treatment of different hemodynamical disorders, these drugs were administered as an adjunctive therapy in POAG patients. Methods: 24 patients with confirmed POAG were included in the study and randomely subdivided into two groups. One group recieved the radical scavenger EGB(751) 120 mg daily for one year and the other part of patients recieved a placebo preparation. The glaucoma medication was not changed and there was no significant difference between both groups. At baseline and after 12 month the central visual field (Humphrey Field Analyzer, program 30-2) was tested, ocular perfusion pressures were measured by Oculo-oscillo-dynamography, the arm-retina time and the arteriovenous passage time was determined videoangiographically. Furthermore blood pressure, intraocular pressure and heart rate were monitored. The central visual field and the ocular perfusion pressures were measured every three month. For statistical analysis the Wilcoxon test was applied. Results: After one year of therapy the patients treated with radical scavengers showed an improvement of their visual field (delta mean deviation 5,2 dB) and an increase of the systolic retinal perfusion pressure ( delta 5,4 mmHg) compared to the placebo group. These results, however, did not prove to be statistically significant (p>0,05). All other parameters did not show any change compared to baseline or comparing placebo and radical scavenger therapy. Conclusion: The results suggest in tendency that an adjunctive glaucoma therapy using radical scavengers might be beneficial in prevention of visual field loss progression and improves ocular perfusion pressures. Larger groups (n>30 patients treated with radical scavengers), however, are necessary to support these first observations.