Treatment of glandma. Role of optic nerve head and cheroidal circulation

采用激光散斑法（NB）测定了实验动物和正常人在使用几种临床或研发中的抗青光眼药物前后视神经头（NB_<ONH>）和脉络膜（NB_<CH>）的组织血流速度和血流量的定量指标。动物研究：在白化兔中，研究了每天2-3周注射两次0.5%倍他洛尔（β -1阻滞剂）、0.5%噻莫洛尔（β -1,2阻滞剂）、2%卡替洛尔（具有内在拟交感神经活性的β -1,2阻滞剂）、0.25%尼帕地洛尔（β -1,2阻滞剂α -1阻断活性）和0.05%布那佐辛（α -1阻滞剂）的效果。单侧卡替洛尔可使双眼NB_<ONH>升高，而单侧噻莫洛尔、倍他洛尔和尼普地洛尔仅能使同侧眼NB_<ONH>升高。局部单侧布那佐辛对双眼无影响。静脉注射钙拮抗剂尼伐地平、尼卡地平或塞莫噻嗪可增加NB_<CH>，而NB_<ONH>仅尼伐地平可增加。为了在猴子身上进行实验，首先制作了专门设计的猴子椅。在实验性青光眼猴眼中，口服另一种钙拮抗剂planidipine对NB_<ONH>无显著影响。人体研究：单侧滴注0.5%卡替洛尔每日2次，3周后使双眼NB_<ONH>轻度升高，而0.5%倍他洛尔仅使同侧眼NB_<ONH>轻度升高，0.5%噻莫洛尔对双眼无影响。口服尼伐地平，而非塞莫噻嗪，在NB_<ONH 100人中增加。这些结果表明，局部给予某些受体阻滞剂可影响视神经头循环，而某些钙拮抗剂可增加视神经头血流量，这可能对治疗青光眼或研究青光眼的发病机制具有重要意义。

A quantitative index of tissue blood flow velocity and blood flow measured by laser speckle method (NB) in the optic nerve head (NB_<ONH>) and choroid (NB_<CH>) were determined in experimental animals and normal human volunteers before and after administration of several antiglaucoma drugs which have been clinically used or were under development.Animal study : In albino rabbits, effects of twice daily 2-3 week instillation of 0.5% betaxolol, a beta-1 blocker, 0.5% timolol, a beta-1,2 blocker, 2% carteolol, a beta-1,2 blocker with intrinsic sympathomimetic activity, 0.25% nipradilol, a beta-1,2 blocker alpha-1 blocking activity, and 0.05% bunazosin, an alpha-1 blocker, were studied. Topical unilateral carteolol increased NB_<ONH> in both eyes, while topical unilateral timolol, betaxolol and nipradilol increased it only in ipsilateral eye. Topical unilateral bunazosin showed no effect in both eyes. Intravenous injection of a calcium antagonist, nilvadipine, nicardipine or semothiazil, increased NB_<CH>, while NB_<ONH> was increased only by nilvadipine. To carry out experiments in monkeys, specially disigned monkey chair was first constructed. In experimental glaucoma monkey eyes, oral planidipine, another calsium antagonist, however, showed no significant effect on NB_<ONH>.Human study : Twice daily 3-week unilateral instillation of 0.5% carteolol slightly increased NB_<ONH> in both eyes, while that of 0.5% betaxolol slightly increased it only in ipsilateral eye and that of 0.5% timolol showed no effect in both eyes. Oral nilvadipine, but not semothiazil, increased in NB_<ONH> humans.These results indicate that some beta-blockers can affect optic nerve head circulation when given topically and that some calcium antagonist can increase optic nerve head blood flow, which may have implications in treating glaucoma or in studying pathogenesis of glaucoma.