The effect of nifedipine on retinal venous pressure of glaucoma patients with the Flammer-Syndrome.

PURPOSE: The purpose was to measure the retinal venous pressure (RVP) in both eyes of primary open-angle glaucoma (POAG) patients before and 3 weeks after treatment with low-dosed Nifedipine. METHODS: This retrospective study included 20 POAG patients who were treated with Nifedipine (5 mg daily) and 20 untreated control POAG patients. In both the treated and untreated control group, a distinction was made between those patients who had the Flammer-Syndrome (FS) and those who did not. The RVP was measured in all patients bilaterally at baseline and 3 weeks later by means of contact lens ophthalmodynamometry and the RVP measurements of the treated POAG patients were compared to the RVPs of the untreated POAG controls. Ophthalmodynamometry is done by applying an increasing force on the eye via a contact lens. The minimum force required to induce a venous pulsation is called the ophthalmodynamometric force (ODF). The RVP is defined and calculated as the sum of ODF and intraocular pressure (IOP) [RVP = ODF + IOP]. RESULTS: The RVP decreased significantly after 3 weeks in both eyes of patients treated with low-dosed Nifedipine compared to the untreated group (mean decrease of 12.5 mmHg (SD 12.5), P < 0.001). A larger response to therapy was found in patients with the FS compared to patients lacking the FS (mean decrease of 16.07 vs. 7.28 mmHg, confidence Interval (CI): 5.2 to 9.3 vs. 12.3 to 19.7; P < 0.001). No significant differences were accounted for in the IOP's of the patients after treatment. In the untreated control group, no significant differences were accounted for either in the RVP or the IOP after 3 weeks. CONCLUSIONS: Treatment with low-dosed Nifedipine decreases RVP in both eyes of glaucoma patients, particularly in those with the Flammer-Syndrome. This effect may be due to the partial inhibition of Endothelin-1 (ET-1) by Nifedipine.

[Pupil perimetry with the Octopus 1-2-3. Initial experiences]. / Pupillenperimetrie mit dem OCTOPUS 1-2-3. Erste Erfahrungen.

PURPOSE: Development of a clinically useful pupil perimetry on an OCTOPUS 1-2-3. MATERIALS AND METHODS: Various test parameters were investigated on a moderately modified OCTOPUS 1-2-3. We evaluated the pupillary responses of 122 eyes of 122 healthy volunteers qualitatively. RESULTS: Pleasing pupillary responses were obtained with the following parameters: 200 ms stimuli, Goldmann size 5 (1.5 degrees), background illumination 3 apostilb. Acoustic signals 0.5 seconds before stimulus presentation were helpful to minimize blinking artifacts. The pupillary reactions were fare stronger in central areas of the visual field than in mid-peripheral areas (i.e. 26 degrees). CONCLUSIONS: Pupil perimetry can be preformed on a moderately modified OCTOPUS 1-2-3. The results reveal considerable inter- and intra-individual variability. Equal pupillary responses at all eccentricities would improve subsequent mathematical evaluation.