Efficacy of Nimodipine Combined with Latanoprost in Treating Open-Angle Glaucoma and Its Influence on Ocular Hemodynamics and Visual Field Defects.

Background: Open-angle glaucoma is a common ophthalmic disease, which has a great impact on the vision of middle-aged and elderly people. Medication plays an important role in the treatment of glaucoma, so finding effective drug treatment is of great significance to improve the quality of life of glaucoma patients. Objective: To explore the curative effect of nimodipine combined with latanoprost in the treatment of open-angle glaucoma and its effect on ocular hemodynamics and visual field defects. Methods: This study retrospectively analyzed the clinical data of 87 patients with open-angle glaucoma who came to the Shanxi Province Fenyang Hospital and The First Affiliated Hospital of Shanxi Datong University for treatment from January 2019 to January 2021. According to different treatment plans, the patients were divided into two groups: an observation group (n = 46) treated with nimodipine combined with latanoprost, and a control group (n = 41) treated by latanoprost monotherapy. Treatment efficacy, hemodynamics, visual field defects, 24-hour peak intraocular pressure, binocular optic disc parameters, adverse reactions and quality of life were recorded and compared between two groups of patients. Results: The overall therapeutic effect of the observation group was significantly better than that in the control group. After treatment, ocular hemodynamics, visual field defects, 24-hour peak intraocular pressure, binocular optic disc parameters and life quality of both groups were obviously improved compared to those before treatment, with more significant improvements in the observation group. In addition, there was no significant difference in the incidence of adverse reactions between the two groups. Conclusion: Nimodipine combined with latanoprost eye drops is effective in the treatment of primary open-angle glaucoma, which could effectively improve the ocular hemodynamics and visual field defects of patients with fewer adverse reactions and higher safety. Therefore, it can be further promoted and used in clinical practice.

Systemic Alpha1-Adrenoceptor Antagonists and Increased Risk of Open-Angle Glaucoma: A Nationwide Population-Based Cohort Study.

Purpose: To examine the risk of open-angle glaucoma (OAG) among patients receiving alpha1-adrenoceptor (α1-AR) antagonists for lower urinary tract symptoms (LUTS). Methods: This was a nationwide, population-based, retrospective cohort study from Asia/Taiwan. One million beneficiaries were randomly sampled from among 27.38 million individuals enrolled in the National Health Insurance program, and subjects with a diagnosis of LUTS from 2001 to 2012 were identified (N = 105,341). After 1:1 propensity score matching by gender, age, comorbid medical diseases, number of all medical visits during the observational period, and index date, 4081 patients were enrolled in the study group, comprised of patients who had taken α1-AR antagonists, and 4081 patients were enrolled in the control group, comprised of patients who had never taken α1-AR antagonists. The incidence and risk of OAG (defined as two ambulatory visits with a ICD-9 diagnosis code 365, excluding ICD-9 diagnosis codes 365.2-365.6, 365.02, 365.03, 365.13, 365.14, and 365.8) were calculated. Results: Patients taking α1-AR antagonists had a higher incidence ratio of 1.86 (95% confidence interval [CI], 1.30-2.65) for developing OAG. After adjusting for age, gender, and comorbidities, the hazard ratio (HR) for OAG for patients taking α1-AR antagonists was 1.66 (95% CI, 1.16-2.39; P = 0.006). Among patients with hypertension, the hazard ratio for OAG associated with taking α1-AR antagonists increased to 1.79 (95% CI, 1.07-2.99; P = 0.003). On the other hand, the association of α1-AR antagonists with OAG was not significant among patients with diabetes mellitus, hyperlipidemia, or older age. Conclusions: The findings of our study suggest an increased risk for OAG among patients taking α1-AR antagonists for LUTS, especially in patients with hypertension.

Relationship between glaucoma and selenium levels in plasma and aqueous humour.

AIM: The aim of the study was to compare selenium levels in plasma and aqueous humour in subjects with and without primary open-angle glaucoma (POAG). METHODS: Forty-seven POAG cases and 54 controls in this case-control study were recruited from surgery patients at the University Physician's Ophthalmology Clinic in Tucson, Arizona, USA. Aqueous humour and plasma selenium were determined by high-performance liquid chromatography ion channel plasma mass spectrometry (HPLC ICP-MS). Potential confounders were assessed via a questionnaire. Biological samples were collected and processed at surgery and analysed for selenium content after collection was complete. Outcome measures included the odds of glaucoma in relationship to plasma selenium, aqueous humour selenium, and the ratio of levels of aqueous humour selenium to plasma selenium. RESULTS: Tertile of selenium and its relationship to POAG was examined. After adjustment for common glaucoma risk factors, the odds of glaucoma in the highest tertile of plasma selenium (OR = 11.3; p = 0.03) and the middle tertile of aqueous humour selenium (OR = 0.06; p = 0.02) was significantly associated with glaucoma. CONCLUSION: Although a causal pathway cannot be inferred from our analysis, our data, added to that of others, suggest that the pathology is selenium-related.