Dorzolamide improves ocular blood flow, reduces IOP in patients with Open Angle Glaucoma

India: A new study has revealed that Dorzolamide improves parameters like end diastolic velocity (EDV) and ocular perfusion pressure (OPP) in all significant ophthalmic arteries such as central retinal artery (CRA), ophthalmic artery (OA), and short posterior ciliary artery (SPCA).

The research findings are published in the Indian Journal of Ophthalmology.

Open-angle glaucoma (OAG) is characterized by progressive retinal ganglion cell death and visual field loss. The prevalence is 3.54% globally in the age range of 40–80 years.

This global prevalence is expected to affect 111.8 million people by 2040. In India, the OAG prevalence is 12.9%.

A significant risk factor in open-angle glaucoma (OAG) pathogenesis is impaired ocular blood flow. Dorzolamide 2% may improve such patients' ocular blood flow (OBF).

OPP and blood flow play a vital role in the pathophysiology of glaucoma, so Improvement of blood flow could be a part of progressive glaucoma management.

As per the hypothesis, dorzolamide will increase the Ocular Blood Flow in Indian OAG patients as assessed in the retrobulbar vasculature by CDI.

Considering this, the efficacy of dorzolamide 2% (DORZOX, Cipla Ltd.) was determined in improving retrobulbar blood flow in an Indian setting (Indian OAG patients) in a study led by Dr Pratheeba D Nivean, Glaucoma and Oculoplasty Consultant, M. N. Eye Hospital Pvt. Ltd.

The critical points of the study are:

• There were 24 healthy subjects and 19 OAG patients.
• Color Doppler imaging (CDI) assessed baseline OBF measurements in glaucoma patients.
• Baseline OPP was calculated for all participants.
• Dorzolamide 2% thrice daily for 12 weeks was given to the Glaucoma patients.
• Mean changes in the CDI parameters of the retrobulbar vessels and OPP posttreatment were the primary efficacy endpoints.
• Mean change in the IOP and adverse events were the study's secondary endpoint.
• In glaucoma patients, baseline OPP was reduced significantly compared to healthy subjects.
• Dorzolamide 2% treatment for 12 weeks increased OPP significantly. There was an increase in end-diastolic velocity (EDV) in all significant ophthalmic arteries.
• IOP reduced significantly, as observed posttreatment, without any reported adverse events.

The researchers wrote,

Our study shows that glaucoma patients have significantly lower OPP.

This first trial in Indian patients evaluated the dorzolamide 2% (DORZOX) effect on OBF in glaucoma patients.

Dorzolamide 2% (DORZOX) improved ocular blood flow (OBF) and EDV, which were the significant hemodynamic changes in the major ophthalmic vessels.

Dorzolamide is promising as it improves ocular blood flow (OBF) and decreases IOP in glaucoma patients. However, more studies should be conducted with a larger sample size to validate these study's findings.

For Financial support and sponsorship, a Research grant was obtained from Cipla Ltd.

Further reading:

Nivean, Pratheeba D et al. Efficacy of dorzolamide in improving ocular blood flow in patients with open-angle glaucoma: The Indian carbonic anhydrase inhibitor trial. Indian Journal of Ophthalmology 70(12):p 4164-4167, December 2022.