The Efficacy of a Monocular Drug Trial in Normal-Tension Glaucoma

PURPOSE: To evaluate the efficacy of a monocular drug trial in eyes with normal-tension glaucoma (NTG). METHODS: This prospective study enrolled 74 patients with NTG. The monocular drug trial was started using latanoprost 0.005% for one week. If the intraocular pressure (IOP) reduction was greater than 15%, the same medication was administered to both eyes for one month. The unadjusted change and adjusted change (the change in the treated eye minus the change in the contralateral eye) in IOP were evaluated, and the predictors of IOP response were analyzed by multivariate linear regression. RESULTS: Among the initial 74 patients, 31 (41.9%) were included; others were excluded because they did not meet the requisite conditions. The most significant predictors of IOP response in the initial eye and subsequent eye were the baseline IOPs in both eyes (beta = 0.907, 0.771, respectively). The adjusted change in IOP of the initial eye had greater association (beta = 0.589) with the IOP after monocular trial in the initial eye than that of unadjusted IOP change (beta = 0.279). The adjusted change in IOP also had greater predictability (beta = 0.348) for IOP after monocular trial in the subsequent eye than that of the unadjusted IOP change (beta = 0.090). CONCLUSIONS: Although the monocular trial in NTG patients had limited efficacy due to its stringent conditions, it was useful for evaluating the IOP response in the initial eye and for predicting the IOP response in the subsequent eye.

Short-Term Effects of Ginkgo biloba Extract on Peripapillary Retinal Blood Flow in Normal Tension Glaucoma

PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.

Short-Term Effects of Ginkgo biloba Extract on Peripapillary Retinal Blood Flow in Normal Tension Glaucoma

PURPOSE: Based on the vascular theory of glaucoma pathogenesis, we wanted to evaluate the effect of Ginkgo biloba extract (GBE) on peripapillary blood flow in patients with normal tension glaucoma (NTG). METHODS: Thirty patients with NTG were randomly placed in the GBE-treated or control groups. The GBE-treated group received 80 mg GBE orally, twice a day for four weeks, and the control group received a placebo twice a day for four weeks. Complete ocular examinations including visual field, Heidelberg retina flowmeter, and systemic examinations were performed on the first study day and on the day treatment was completed. RESULTS: After GBE treatment, the mean blood flow, volume, and velocity increased at almost all points, and there was a statistically significant increase in blood flow at almost all points, in comparison to the placebo. Blood volume significantly increased only in the superior nasal and superior temporal neuroretinal rim areas. GBE also significantly increased blood velocity in areas of the inferior temporal neuroretinal rim and superior temporal peripapillary area. CONCLUSIONS: GBE administration appears to have desirable effect on ocular blood flow in NTG patients.