The alterations of choroidal thickness and ocular pulse amplitude associated with medical treatment in primary open angle glaucoma cases

Aim: To investigate the effect of several medical treatment options on choroidal thickness (CT) and ocular pulse amplitude (OPA) in primary open angle glaucoma (POAG) cases. Materials and Metods: The study was performed at the Karadeniz Technical University Faculty of Medicine, Department of Ophthalmology between December 2013 and June 2015. 67 eyes of 41 newly diagnosed POAG cases and 52 eyes of 26 healty volunteers were prospectively evaluated. The patients were randomly divided into two groups and bimatoprost 0.03 % was started Group I, timolol 0.5 % + brinzolamid 1 % fixed combination was also started Group II as treatment. The control examinations were performed in all cases at 2nd, 4th, 8th week after the beginning of treatment. The detailed ophthalmological examination was performed in all cases including intraocular pressure (IOP) and OPA measurements with Pascal Dynamic Contour Tonometer (DCT); subfoveal CT, peripapillary retinal nerve fiber layer ( RNFL ) and ganglion cell complex (GCC) analysis with optic cohorence tomography (OCT) at all visits. The obtained data were analyzed statistically. Results: 119 eyes of 67 cases with a mean age of 51.76±13.4 years, 37 females (55.2 %), 30 males (44.8 %), were included in the study. Mean IOP values were measured 25.5±4.7 / 25.1±5.2 / 16.1±2.9 mm Hg, mean OPA values were measured 3.7±1 / 3.6±1.4 / 2.4±0.6 mm Hg and mean CT values were measured 269.4±83 / 264.5±84.4 / 320.1±56.6 μm, respectively before treatment in Group I, Group II and control group. Mean IOP values were measured 18.3±2.6 / 18.1±3.4 / 15.7±2.9 mm Hg, mean OPA values were measured 2.9±1.2 / 2.8±1.5 / 2.3±0.8 mm Hg and mean CT values were measured 290.2±87.3 / 271.8±82.5 / 319.3±56.8 μm, respectively, after treatment in the last examination in Group I, Group II and control group. A similar and significant reduction of IOP and OPA was determined in cases using bimatoprost 0.03 % and timolol 0.5 % + brinzolamid 1 % fixed combination after treatment (p<0.001, for the all). There was no significant difference in the change of IOP and OPA between Group I and Group II (p=0.998, p=0.993, respectively). Statistically significant increase of CT was determined in cases using bimatoprost 0.03 % and timolol 0.5 % + brinzolamid 1 % fixed combination after treatment (p<0.001, p=0.003, respectively). There was a statistically significant difference between glaucoma groups (Group I, Group II) and control group in terms of change of CT (p<0.001, p=0.031, respectively). In addition, it was detected a more significantly increase of CT in cases using bimatoprost 0.03 % than in cases using timolol 0.5 % + brinzolamid 1 % fixed combination (p=0.048). Conclusion: The level of decrease of IOP and OPA by using bimatoprost and timolol + brinzolamid fixed combination was the same. However, these medications, especially more conspicuous in bimatoprost, were seen to cause a significant increase in CT.