International ophthalmology · 1999
Fludrocortisone in the treatment of systemic hypotension in primary open-angle glaucoma patients.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Gugleta K, Orgül S, Stümpfig D, Dubler B, Flammer J
Аннотация
BACKGROUND: Fludrocortisone is a potent mineralocorticoid, which has no known direct vasoactive properties, and is the first-line drug for treatment of orthostatic hypotension. The present study evaluated the systemic hemodynamic effects of fludrocortisone treatment in glaucoma patients.
PATIENTS AND METHODS: A retrospective analysis of the charts of glaucoma patients of the University Eye-Clinic Basel was performed. Twenty-two patients with open-angle glaucoma under treatment with fludrocortisone were selected. The selected patients had one 24-h blood pressure recording immediately prior to treatment with fludrocortisone and one recording at least 2 months after starting the treatment. Parallel to blood pressure recordings, diurnal intraocular tension curve recordings and visual field testings were carried out. In addition, twelve patients also had nail-fold video-capillaroscopy.
RESULTS: IOP and visual fields remained stable. The average values for all systemic blood-pressure readings showed an improvement in the follow-up compared to primary examination. Mean (+/- SD) night-to-day ratio ('nocturnal dips') of systolic, diastolic and mean arterial blood pressure decreased from 13.6 +/- 4.3%, 16.9 +/- 5.2% and 15.9 +/- 3.5%, respectively, to 9.9 +/- 5.9% (p = 0.01), 13.2 +/- 4.3% (p = 0.044) and 11.7 +/- 3.9% (p = 0.0004). Baseline capillary blood-flow velocity increased and capillary blood-flow standstill time after cold provocation decreased significantly under fludrocortisone therapy.
CONCLUSION: Hemodynamic parameters show a tendency towards improvement in a magnitude which might be of clinical relevance.
PATIENTS AND METHODS: A retrospective analysis of the charts of glaucoma patients of the University Eye-Clinic Basel was performed. Twenty-two patients with open-angle glaucoma under treatment with fludrocortisone were selected. The selected patients had one 24-h blood pressure recording immediately prior to treatment with fludrocortisone and one recording at least 2 months after starting the treatment. Parallel to blood pressure recordings, diurnal intraocular tension curve recordings and visual field testings were carried out. In addition, twelve patients also had nail-fold video-capillaroscopy.
RESULTS: IOP and visual fields remained stable. The average values for all systemic blood-pressure readings showed an improvement in the follow-up compared to primary examination. Mean (+/- SD) night-to-day ratio ('nocturnal dips') of systolic, diastolic and mean arterial blood pressure decreased from 13.6 +/- 4.3%, 16.9 +/- 5.2% and 15.9 +/- 3.5%, respectively, to 9.9 +/- 5.9% (p = 0.01), 13.2 +/- 4.3% (p = 0.044) and 11.7 +/- 3.9% (p = 0.0004). Baseline capillary blood-flow velocity increased and capillary blood-flow standstill time after cold provocation decreased significantly under fludrocortisone therapy.
CONCLUSION: Hemodynamic parameters show a tendency towards improvement in a magnitude which might be of clinical relevance.