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Propósito: Estudiar los cambios hemodinámicos retrobulbares mediante ecografía doppler color, en pacientes hipertensos oculares (HTO) en tratamiento con Combigan® versus placebo. Método: Treinta pacientes randomizados en 2 grupos paralelos fueron incluidos en un estudio prospectivo y a doble ciego; quince de ellos en tratamiento con Combigan® y quince en tratamiento con placebo, durante un periodo de 3 meses. Se obtuvieron medidas de la presión intraocular (PIO) y del flujo sanguíneo a nivel de la arteria central de la retina (ACR) y la arteria oftámica en el momento basal y a los 3 meses. Resultados: Combigan® redujo significativamente la PIO tras tres meses de tratamiento (p=0,001). Los parámetros hemodinámicos basales fueron similares entre los grupos placebo y tratamiento. Los pacientes tratados con Combigan® mostraron un descenso estadísticamente significativo del índice de resistencia de la ACR (p=0,007). Conclusiones: Los pacientes tratados durante 3. meses con Combigan® mostraron un descenso estadísticamente significativo del índice de resistenciade la ACR que podría explicarse por el descenso de PIO. Purpose: This study was undertaken to compare the ocular haemodynamic effects of Combigan® versus placebo in patients with ocular hypertension (OHT). Methods: Thirty patients with OHT were included in a controlled, randomised, double blind study in two parallel groups; 15 were randomised to receive Combigan® and 15 to receive placebo for a period of 3 months. At baseline and at 3 months retrobulbar blood flowmeasurements of the ophthalmic artery (OA) and central retinal artery (CRA) were taken using colour Doppler imaging (CDI) ultrasound, concurrently with intraocular pressure (IOP). Results: Combigan® significantly reduced IOP after 3 months of treatment (P = 0.001), whereas placebo showed no significant change in IOP. The baseline haemodynamic parameters were similar between treatment and placebo groups. Patients treated with Combigan® showed a statistically significant decrease in CRA resistive index (P = 0.007). Conclusions: Patients treated for 3 months with Combigan® showed a significant decrease of CRA resistive index that could be explained by the decrease in IOP.

Resumen Proposito Estudiar los cambios hemodinamicos retrobulbares mediante ecografia doppler color, en pacientes hipertensos oculares (HTO) en tratamiento con Combigan ® versus placebo. Metodo Treinta pacientes randomizados en 2 grupos paralelos fueron incluidos en un estudio prospectivo y a doble ciego;quince de ellos en tratamiento con Combigan® y quince en tratamiento con placebo, durante un periodo de 3 meses.Se obtuvieron medidas de la presion intraocular (PIO) y del flujo sanguineo a nivel de la arteria central de la retina (ACR) y la arteria oftamica en el momento basal y a los 3 meses. Resultados Combigan ® redujo significativamente la PIO tras tres meses de tratamiento (p = 0,001). Los parametros hemodinamicos basales fueron similares entre los grupos placebo y tratamiento. Los pacientes tratados con Combigan ® mostraron un descenso estadisticamente significativo del indice de resistencia de la ACR (p = 0,007). Conclusiones Los pacientes tratados durante 3. meses con Combigan® mostraron un descenso estadisticamente significativo del indice de resistenciade la ACR que podria explicarse por el descenso de PIO.

Elad Moisseiev, Shimon Kurtz, Moshe Lazar, Gabi ShemeshDepartment of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, IsraelBackground: The purpose of this study was to evaluate the safety and efficacy of a fixed combination of timolol maleate 0.5% + brimonidine tartrate 0.2% (Combigan®) for reduction for intraocular pressure (IOP) in patients with glaucoma when the dose frequency is increased from twice to three times daily.Methods: The patients included had either primary open angle glaucoma or ocular hypertension. Those who were previously on treatment completed a drug washout period prior to inclusion. IOP was measured at baseline, after 4 weeks of treatment with Combigan twice daily, and again after a further 4 weeks of Combigan three times daily. Blood pressure, heart rate, and oxygen saturation were also recorded at each assessment.Results: Thirty-one eyes from 31 patients were included. Increasing the Combigan dose frequency resulted in a statistically significant (P < 0.001) additional reduction in IOP of 2.25 ± 1.18 mmHg, corresponding to a further 10.3% reduction in IOP from baseline. No local or systemic adverse effects were documented.Conclusion: Treatment with Combigan three times daily was more effective in reducing IOP than the twice-daily regimen, with no increase in adverse effects.Keywords: Combigan®, timolol, brimonidine, glaucoma, dose frequency