Effect of Tafluprost and Tafloprost/Timolol on the Optic Nerve Head, Peripapillary and Macular Microcirculation According to OCT-Angiography

Relevance. The ability of antiglaucoma drugs to improve ocular hemoperfusion is an important aspect of their action. Tafluprost is the first prostaglandin analogue (PA) containing no preservatives.  The efficacy and safety of tafluprost, as well as tafluprost/timolol  fixed combination (FC), was demonstrated in randomized multicenter  trials. However, there is no literature on the effect of  tafluprost and it’s FC on peripapillary and macular blood flow.

Purpose. to assess the effect of tafluprost and tafloprost/timolol on the microcirculation in the optic nerve head, peripapillary area and  macula in patients with primary open-angle glaucoma (POAG)  according to OCT angiography (OCT-A).

Patients and methods. OCT-A was performed in dynamics with an interval of a week in 36 patients (36 eyes) with a newly diagnosed  initial stage of POAG, 12 received tafluprost, 12 — tafluprost/timolol  FCs, 12 eyes represented control group (no drugs were prescribed).  The change in IOP, mean perfusion pressure (PP) of the eye, and  vessel density (VD) inside the optic nerve head (ONH) (inside disc),  as well as in the peripapillary retina and macula were evaluated by  comparing paired repeated observations using the median growth analysis.

Results. In the tafluprost group there was a decrease in IOP by 19.4 % and an increase in PP by 8.7 % from the reference level. In the  tafluprost/timolol group, these figures were 43 % and 30.1 %,  respectively. OCT-A values did not change reliably, except for VD  inside Disc: in the tafluprost group, the median growth was –2.28 (p = 0.02), for the tafluprost/ timolol group — –1.82 (p = 0.03). These  changes were obtained in 11 patients of 12 in each group under  treatment. In patients who did not receive treatment, all indicators  remained unchanged.

Conclusions. The results of this study showed a decrease in the density of the microcirculatory bed in the ONH in patients with initial  glaucoma against the background of the tafluprost and  tafluprost/timolol treatment, which can be explained by the  restoration of autoregulation of the ocular blood flow in conditions of  pronounced hypotensive drugs effect.

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