Based on the body of evidence implicating ocular blood flow disturbances in the pathogenesis of glaucoma, there is great interest in the investigation of the effects of antiglaucoma drugs and systemic medications on the various ocular vascular beds. The primary aim of this article was to review the current data available on the effects of antiglaucoma drugs and systemic medications on ocular blood flow. We performed a literature search in November 2002, which consisted of a textword search in MEDLINE for the years 1968-2002. The results of this review suggest that there is a severe lack of well-designed long-term studies investigating the effects of antiglaucoma and systemic medications on ocular blood flow in glaucomatous patients. However, among the 136 articles dealing with the effect of antiglaucoma drugs on ocular blood flow, only 36 (26.5%) investigated the effects of medications on glaucoma patients. Among these 36 articles, only 3 (8.3%) were long-term studies, and only 16 (44.4%) were double-masked, randomized, prospective trials. Among the 33 articles describing the effects of systemic medications on ocular blood flow, only 11 (33.3%) investigated glaucoma patients, of which only one (9.1%) was a double-masked, randomized, prospective trial. Based on this preliminary data, we would intimate that few antiglaucoma medications have the potential to directly improve ocular blood flow. Unoprostone appears to have a reproducible antiendothelin-1 effect, betaxolol may exert a calcium-channel blocker action, apraclonidine consistently leads to anterior segment vasoconstriction, and carbonic anhydrase inhibitors seem to accelerate the retinal circulation. Longitudinal, prospective, randomized trials are needed to investigate the effects of vasoactive substances with no hypotensive effect on the progression of glaucoma.

中文翻译：

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抗青光眼和全身药物对眼血流量的影响。

基于在青光眼发病机理中涉及眼部血流紊乱的大量证据，对抗青光眼药物和全身药物对各种眼部血管床的作用的研究引起了极大兴趣。本文的主要目的是回顾有关抗青光眼药物和全身药物对眼血流的影响的现有数据。我们在2002年11月进行了文献搜索，其中包括1968-2002年在MEDLINE中进行的文字搜索。这项审查的结果表明，严重缺乏设计良好的长期研究，以研究抗青光眼和全身药物对青光眼患者眼血流量的影响。然而，在涉及抗青光眼药物对眼血流量影响的136篇文章中，只有36篇（26。5％）调查了药物对青光眼患者的影响。在这36篇文章中，只有3篇（8.3％）是长期研究，只有16篇（44.4％）是双重掩盖的随机前瞻性试验。在描述全身性药物对眼部血流的影响的33篇文章中，只有11篇（占33.3％）被调查过的青光眼患者，其中只有一项（9.1％）属于双盲，随机，前瞻性试验。根据这些初步数据，我们可以得出结论，很少有抗青光眼药物具有直接改善眼部血流的潜力。Unoprostone似乎具有可重现的抗内皮素1效应，倍他洛尔可能发挥钙通道阻滞作用，阿克拉克隆定持续导致前段血管收缩，碳酸酐酶抑制剂似乎加速了视网膜循环。纵向，预期，