The use of flunarizine in the management of low-tension glaucoma: A Color Doppler study

Abstract

The authors assess the efficacy of flunarizine in improving blood flow and perimetric indices in low-tension glaucoma (LTG). A group of 20 patients with LTG well-compensated by medical treatment underwent Color Doppler Imaging (CDI) of the ophthalmic artery and posterior ciliary arteries with peak systolic velocity (PSV) and Purcelot's index (PI) evaluation. Computerized perimetry was also performed to assess MD, SF and CPSD. The parameters were measured before and after three months' therapy with flunarizine. Data before and after flunarizine treatment were: Ophthalmic artery - PSV 33.261 ± 1.628 cm/sec vs 35.746 ± 0.800 cm/sec (p < 0.001); PI 0.697 ± 0.017 vs 0.627 ± 0.031 (p < 0.001); Posterior ciliary arteries - PSV 9.385 ± 0.751 cm/sec vs 10.738 ± 1.566 cm/sec (p < 0.005); PI 0.673 ± 0.056 vs 0.589 ± 0.023 (p < 0.001). The perimetric indices were modified as follows: MD -11.002 ± 6.574 vs -6.604 ± 6.426 (p < 0.006); SF 5.05 ± 5.717 vs 2.937 ± 1.780 (p < 0.193); CPSD 10.198 ± 13.392 vs 3.445 ± 2.709 (p < 0.093). Oral administration of flunarizine, a calcium channel-blocker which acts at a vascular and neuronal level, improves the blood flow indices for the optic nerve, improving thereby the perimetric indices in LTG.